Encephalopathy (cont.)
What are the symptoms of encephalopathy?
Despite the numerous and varied causes of
encephalopathy, at least one symptom present in all cases is an altered mental
state. The altered mental state may be subtle and develop slowly over years (for
example, in hepatitis the
decreased ability to draw simple designs, termed apraxia) or be profoundly
obvious and develop rapidly (for example, brain anoxia leading to coma or death
in a few minutes). Often, symptoms of altered mental status can present as
inattentiveness, poor judgment, or poor coordination of movements.
Other symptoms that may occur include:
Often the severity and type of symptoms are related to the severity and cause of
the brain disease or damage. For example, alcohol-induced liver damage
(alcoholic cirrhosis) can result in involuntary hand tremors
(asterixis), while severe anoxia (lack of oxygen) may result in coma with no
movement.
How is encephalopathy diagnosed?
The diagnosis of encephalopathy is usually done by
clinical tests done during the physical examination (mental status tests, memory
tests, coordination tests) that document an altered mental state. With most
cases, findings on clinical tests either diagnose or presumptively diagnose
encephalopathy. Usually, the diagnosis occurs when the altered mental state
accompanies another primary diagnosis such as chronic liver disease, kidney
failure, anoxia, or many other diagnoses.
Consequently, physicians may utilize
several different tests at the same time to diagnose both the primary condition
(the cause of encephalopathy) and the encephalopathy itself. This approach to
diagnosis is done by most physicians, because many doctors view encephalopathy
as a complication that
occurs because of a primary underlying health problem. The most frequently
utilized tests are listed below with some of the major primary causes the tests
may help diagnose:
- Complete blood count or CBC (infections, loss of blood)
- Blood pressure (high or low blood pressure)
- Metabolic tests (blood levels of
electrolytes,
glucose, lactate,
ammonia,
oxygen, and liver enzyme levels)
- Drugs or toxin levels (alcohol,
cocaine, amphetamines, and many others)
- Blood and body fluid cultures and analyses (infections of many types)
- Creatinine (kidney function)
- CT and MRI scans (brain swelling, anatomical abnormalities, infections)
- Doppler ultrasound
(abnormal blood flow to tissues, abscesses)
- Encephalogram or EEG (brain damage, abnormal brain wave patterns)
- Auto-antibody analysis (dementia caused by antibodies that destroy neurons)
This list is not exhaustive, and not all of the above tests need to be done
to reach a diagnosis; specific testing is usually ordered by the treating
physician according to the symptoms and history of the patient.
Next: What is the treatment for encephalopathy? »
- Liver Blood Tests - Learn about liver blood tests used to detect liver damage disease such as fatty liver, cirrhosis, hepatitis, Tylenol liver damage, and more. This includes measuring the aminotransferases enzymes (AST and ALT levels)
- Low Blood Pressure - Learn about low blood pressure (hypotension). Low blood pressure is blood pressure below normal and symptoms may include: lightheadedness, dizziness, fainting upon standing (orthostatic hypotension). There are many causes of low blood pressure, and treatment is dependant upon the cause.
- Creatinine Blood Test - Learn more about the creatinine blood test, a test that measures kidney function. Abnormal creatinine levels in the blood may indicate kidney disease.
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