Encephalopathy - Symptoms

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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 serious symptoms that may occur include:

  • lethargy,
  • dementia,
  • seizures,
  • tremors,
  • muscle twitching and myalgia,
  • Cheyne-Stokes respirations (an altered breathing pattern seen with brain damage and coma), and
  • coma.

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. Other symptoms may not be as severe and be more localized such as cranial nerve palsies (damage to one of the 12 cranial nerves that exit the brain). Some symptoms may be very subtle and result from repeated injury to the brain tissue. For example, chronic traumatic encephalopathy (CTE), due to injury like concussions repeatedly sustained by football players and others who play contact sports, may cause slow changes over time that are not easily diagnosed. Such injury may lead to chronic depression or other personality changes that can result in life-changing consequences.

Even infants and children can suffer encephalopathy. Similar symptoms can occur in the perinatal period if, the neonate had any compromise to brain blood flow during its development. Rasmussen's encephalitis is a rare disease that is seen in children that progresses to intractable seizures if untreated. It may be due to autoantibody development. Another rare form of encephalopathy that usually develops in younger people (about ages 4 to 20 years) is the MELAS syndrome ("Mitochondrial Encephalopathy, Lactic Acidosis, Stroke-like episodes") due to faulty DNA in the patient's mitochondria (a tiny part within the cell that is responsible for energy conversion).

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Comment from: Terrigm, 13-18 Male (Caregiver) Published: November 22

My sixteen year old son suffered brain damage as a result of taking Humira and methotrexate for his juvenile arthritis. The doctor started him on this when he was 13. He has regressed to the level of a 5 year old and is having to learn things all over again. Today his condition was finally given the name, encephalopathy. He has a little trouble moving his hands and arms although he can still do basic care things for himself. He has significant memory loss, he uses poor judgment, trying to eat raw foods that he shouldn't. He can no longer process the fact that he needs to read and follow instructions, so he can no longer prepare simple cooked foods. He leaves burners going on the stove, walks around naked because his mind is like a toddler. He's not embarrassed to be seen unclothed. He needs close supervision.

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