Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). During the final stage of this deadly disease, the patient is likely to experience rapid deteriorating in his cognitive functions. This condition is called hepatic encephalopathy, which occurs when a severely damaged liver is not able to remove toxic substances such as ammonia from the blood. These toxins build up and concentrate in the brain.
Signs and Smptoms
Hepatic encephalopathy symptoms can either begin and worsen slowly, or they may begin all of a sudden and be severe from the start. In its mild form, hepatic encephalopathy is easy to ignore. Its early signs, such as forgetfulness and irritability, are easy to misinterpret as part of aging or a stressful life situation.
As the illness progresses, the symptoms become more severe, however. Soon, the patient finds it hard to sleep and concentrate, he becomes more and more irritable, his personality might change and he might suffer from muscle contractions. Some patients say they feel mentally foggy, and they may make poor judgments. Patients' handwriting deteriorates.
Liver failure will bring even more severe symptoms, such as agitation, excitement, disorientation, amnesia, seizures, drowsiness and confusion. A patient's behavior might become inappropriate, his speech can slur and he might have abnormal movements or shaking of hands or arms. As the patient slips into hepatic coma, his brain swells and he dies.
Treatment
Hospitalization is required to treat hepatic encephalopathy. After the doctor has identified the factors that have caused this condition, treatments can begin. This condition can be helped with antibiotics, probiotics, or so called “good bacteria," and branched-chain amino acid supplements. Rifaximin antibiotic seems to be effective for treating hepatic encephalopathy.
Some doctors recommend that the patient lower his protein consumption in order to lower the ammonia production. It is important to know, however, that a diet in which too little protein in consumed might cause malnutrition. Sedatives, tranquilizers,and medication containing ammonium should be avoided since they can harm the liver. Lactulose may be given to prevent intestinal bacteria from creating ammonia. Once the condition has been treated, a patient may need a liver transplant.
Prognosis
Acute hepatic encephalopathy may be treatable, and recovery can be possible. In acute liver failure, the development of severe hepatic encephalopathy is likely to be fatal. In these cases, even if the hepatic encephalopathy were helped, it keeps on coming back and worsens every time. Approximately 80% of the patients who go into a coma will die.
