Encephalopathy (cont.)
What is the prognosis (outlook) for encephalopathy?
The prognosis for a patient with encephalopathy depends on the initial causes
and, in general, the length of time it takes to reverse, stop, or inhibit those
causes. Consequently, the prognosis varies from patient to patient and ranges
from complete recovery to a poor prognosis that often leads to permanent brain
damage or death. One good example of this highly variable prognosis are patients
that get encephalopathy from hypoglycemia. If patients with hypoglycemia are
given glucose at the first signs of encephalopathy (for example, irritability,
mild confusion), most patients recover completely. Delays in correcting
hypoglycemia (hours to days) may lead to seizures or coma which may be halted by
treatment with complete or partial recovery (minimal permanent brain damage). A
long delay or multiple delays in treatment can lead to a poor prognosis with
extensive brain damage, coma, or death.
Although the symptoms and time frame vary widely from
patient to patient and according to the initial causes of encephalopathy (see
above sections for examples of causes), the prognosis of each case usually
follows the pattern described in the hypoglycemic example above and depends upon the extent and
rapidity with which the underlying cause is treated. The doctor or team of
doctors treating the underlying cause of encephalopathy can offer the best
information on the individual's prognosis.
Can encephalopathy be prevented?
Many cases of encephalopathy can be prevented. The key to prevention is to
stop or limit the chance of developing any of the multitudes of causes of
encephalopathy. If encephalopathy develops, the quicker the underlying cause is
treated, the more likely that severe encephalopathy can be prevented.
Examples
of prevention (and situations to avoid) are listed below:
- Diabetic encephalopathy: take daily glucose checks and
always check that insulin administration is the correct dosage.
- Hepatic encephalopathy: avoid alcohol intoxication, drug overdoses, and IV
injections of illegal drugs.
- Anoxic encephalopathy: prevent
choking on food, avoid risky behavior that
could lead to head and neck trauma, avoid exposure to carbon monoxide.
- Hypertensive encephalopathy: monitor blood pressure; take
antihypertensive
medication as directed and do not stop medications or change medication without
consulting your doctor.
- Infectious encephalopathy: avoid physical contact with individuals known
to be infected with organisms that may cause encephalopathy such as N.
meningitidis or Shigella.
- Uremic encephalopathy: do not skip or avoid scheduled dialysis, take all
medications as directed and have frequent assessments of mental status.
Methods for prevention of encephalopathy are about as numerous as the
underlying causes; however, some cases of encephalopathy may not be preventable
(for example, congenital and accidental traumatic encephalopathy).
Next: Encephalopathy At A Glance »
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