Porto systemic encephalopathy

[Guest guest]

Porto systemic encephalopathy is a mental status change related to liver

disease. The liver disease doesn not need to be cirrhosis, as hepatitis can

cause this to happen as well. The old school says that ammonia is the culprit,

but newer studies seem to suggest that there are many different toxins

responsible for it. It is an scary, sometimes ugly thing to witness and even

more frightening thing to experience. It feels like being very very drunk, and

in a way the person is in fact drunk, because the miriad of toxins causing PSE

mimic alcohol. One recent study supports a type of benzo diazipine that our own

bodies make, but people suffering from liver disease cannot filter out. Benzo

diazipines are a family of drugs including librium, valium and ativan.

It's bad enough for a recovering alcoholic to be struggling to stay clean and

sober only to experience drug abuse without taking a single pill!

I could list all the known toxins but it would not do any good. There are only

a few known treatments for PSE. All have to come from a doctor, and be watched

carefully by a doctor. A patient suffering from mental status change needs to be

seen as an emergency. Calling 911 would not be over dramatic. There are several

stages to this condition, and full comatose is not far from the stage before it.

A person could be slurring thier speech, and go in to a coma in minutes.

One of the earliest manifestations of hepatic encephalopathy is

" day-night reversal. " In other words, affected individuals tend to

sleep during the day and stay awake at night. Another early

manifestation is impairment in spatial perception. This can be made

apparent by noting the patient's poor ability to copy or draw various

simple images, e.g., cube, star, clock. This deficit can also be

demonstrated by administering a test that has the patient connect a

number of randomly-placed dots on a sheet of paper (the " trail test " or

" numbers connecting test " ) There is a connect the numbers test you can download

from our files section. Just click on the file and " save as " .

Here are the 4 stages of PSE-

* Grade 1 - Trivial lack of awareness; Euphoria or anxiety; Shortened

attention span; Impaired performance of addition or subtraction. 67% of

cirrhotic patients may have 'minimal hepatic encephalopathy'.

* Grade 2 - Lethargy or apathy; Minimal disorientation for time or place;

Subtle personality change; Inappropriate behavior.

* Grade 3 - Somnolescence to semistupor, but responsive to verbal stimuli;

Confusion; Gross disorientation

* Grade 4 - Coma(unresponsive to verbal or noxious stimuli)Here is a good link

for this topic

http://en.wikipedia.org/wiki/Hepatic_encephalopathy

Most of us here who have liver disease are taking lactulose or Crystalose for

the treatment of PSE.

Love, Bobby