Encephalopathy - Diagnosis

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What types of tests and exams led to the diagnosis of encephalopathy in you, a friend, or relative?

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How is encephalopathy diagnosed?

The diagnosis of encephalopathy is usually made with clinical tests done during the physical examination (mental status tests, memory tests, and coordination tests) that document an altered mental state. In 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 encephalopathy is 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 or loss of blood)
  • Blood pressure (high or low blood pressure)
  • Metabolic tests (blood levels of electrolytes, glucose, lactate, ammonia, oxygen, and liver enzymes)
  • 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, or infections)
  • Doppler ultrasound (abnormal blood flow to tissues or abscesses)
  • Encephalogram or EEG (brain damage or abnormal brain wave patterns)
  • Autoantibody analysis (dementia caused by antibodies that destroy neurons)
  • Review of the person's medications as some medications (for example, cyclosporine) may be responsible for symptoms

This list is not exhaustive, and not all of the above tests need to be done on every patient. Specific testing is usually ordered by the treating physician according to the symptoms and history of the patient.

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See what others are saying

Comment from: spipkin, 65-74 Female (Patient) Published: September 09

My encephalopathy was caused by a reaction due to medication for chronic pain.

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Comment from: Frustrated, 65-74 Male (Caregiver) Published: December 10

My dad recently had a TIPS (transjugular intrahepatic portosystemic shunt) procedure done and one of the side effects was him developing hepatic encephalopathy. He does have medication induced cirrhosis of the liver and had portal hypertension which in turn gave us the only option of this procedure. He has good days and really bad days. He is currently taking lactulose 3 times a day, and if needed sometimes more but still has bad days. It is so hard to see someone go through this awful struggle with memory and loss of hope. We keep positive and celebrate the good days.

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