Encephalopathy

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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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. This highly variable prognosis is exemplified by 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: Follow your prescribed diabetes management plan, including taking glucose measurements when appropriate. Take all medications as directed.
  • 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 a 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).

Medically Reviewed by a Doctor on 10/29/2015

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