Encephalopathy - Types, Causes, Symptoms, Diagnosis, and Treatment

What Is Encephalopathy?

The term encephalopathy refers to an illness, injury, or malfunction of the brain. It can cause a wide range of symptoms, from minor memory loss and subtle personality changes to severe dementia, seizures, coma, and death. It is characterized by a change in the mental state that is occasionally accompanied by physical symptoms, for example, poor coordination of arm and leg movements.

In most cases, the term encephalopathy is preceded by a number of adjectives that define the cause, reason, or special circumstances that led to the patient's brain disorder. Anoxic encephalopathy, for example, refers to brain damage caused by a lack of oxygen, while hepatic encephalopathy refers to brain malfunction caused by liver disease. Wernicke's encephalopathy and metabolic encephalopathy are two examples of physical issues or syndromes that result in brain dysfunctions.

What Are the Types of Encephalopathy and Their Causes?

1. Chronic Traumatic Encephalopathy: Injuries to the brain or multiple traumas can cause this sort of encephalopathy. These head injuries cause nerve damage in the brain resulting in the syndrome. It is most commonly encountered among boxers, football players, and military personnel who have been harmed by explosions.

2. Hepatic Encephalopathy: Hepatic encephalopathy is a type of encephalopathy caused by liver illness. When the liver is not working properly, the toxins that the liver normally eliminates are permitted to build up in the bloodstream and eventually reach the brain. This makes it difficult for the brain to function properly. It can occur in patients who have cirrhosis or who have taken an overdose of Acetaminophen or other drugs.

3. Hypoxic Ischemic Encephalopathy: This is a sort of brain injury that occurs when the brain does not receive adequate oxygen. This can result in long-term damage or dysfunction of the brain. It is caused by a shortage of oxygen in the brain, which can happen when a newborn is exposed to alcohol while they are still in the womb. It can also occur after cardiac arrest, carbon monoxide poisoning, drug overdose, or near-drowning experience.

4. Hypertensive Encephalopathy: Hypertensive encephalopathy is caused by untreated high blood pressure for an extended period of time which can result in brain edema, leading to hypertensive encephalopathy and brain damage.

5. Toxic Metabolic Encephalopathy: Toxins, infections, or organ failure can cause toxic-metabolic encephalopathy. When the body's hormones, electrolytes, or other substances are out of balance, it might affect how the brain functions. This can also involve the existence of an illness or hazardous compounds in the body. When the underlying chemical imbalance is rectified, or the offending infection or toxin is removed, the encephalopathy usually disappears.

6. Wernicke’s Encephalopathy: This disorder, also known as Wernicke's disease, is caused by a lack of vitamin B1. A vitamin B1 shortage can be caused by long-term alcoholism, inadequate nutritional consumption, and poor food absorption.

7. Hashimoto’s Encephalopathy: This type is associated with Hashimoto's disease, a thyroid disorder. The cause is unknown, although it is possible that the immune system attacks the brain and causes it to malfunction.

8. Uremic Encephalopathy: Kidney failure leads to uremic encephalopathy. This condition might range from minor confusion to a full-blown coma.

9. Glycine Encephalopathy: Glycine encephalopathy is a genetic or inherited disorder in which the brain's glycine levels are unusually high. Glycine encephalopathy symptoms commonly emerge in newborns shortly after birth.

10. Infectious Encephalopathy: It is caused by a rare category of illnesses known as prion diseases or transmissible spongiform encephalopathies. The mutation of a protein called a prion is connected to these degenerative disorders.

What Are the Symptoms of Encephalopathy?

A disturbed mental state is the most common symptom of encephalopathy. This may necessarily involve:

• Having difficulty staying focused.

• Having difficulty thinking or processing information.

• Forgetting things, acting out of character.

• Finding it difficult to be attentive and concentrate.

• Feeling exhausted.

• Feeling lethargic and drowsy.

These signs and symptoms may worsen with time. The degree of advancement is determined by the type of encephalopathy and its severity. A person experiencing encephalopathy may suffer from the following symptoms in addition to their altered mental state:

• Uncontrollable muscle twitching.

• Uncontrollable eye motions.

• Muscular weakness.

• Shaking.

• Difficulty swallowing or speaking.

• Seizures.

How Is Encephalopathy Diagnosed?

During a physical examination, clinical tests such as memory tests, mental status tests, and coordination tests that record an altered mental state are commonly used to diagnose encephalopathy. The diagnosis is usually made when the change in the mental state occurs in conjunction with another primary illness, such as kidney failure, chronic liver disease, anoxia, or a variety of other conditions.

As a result, doctors may use a combination of tests to diagnose the etiology of encephalopathy as well as the encephalopathy itself. Since encephalopathy is a complication that emerges as a result of a major underlying health problem, most physicians employ this approach to diagnosis. The most commonly used tests are mentioned below, along with some of the most common primary causes that the tests may be used to diagnose:

• CBC or complete blood count.

• Computed tomography (CT) or magnetic resonance imaging (MRI) scans.

• Metabolic tests such as blood levels of glucose, lactate, ammonia, electrolytes, oxygen, and liver enzymes.

• Electroencephalograms or EEGs employ a technique for capturing the brain's electrical activity.

• Blood tests detect diseases, germs, viruses, poisons, hormonal or chemical imbalances, and prions.

• Spinal fluid test.

What Are the Treatments for Encephalopathy?

The treatment for encephalopathy depends on what caused it in the first place. Drugs to address your symptoms, as well as medications or surgery to treat the underlying cause, may be used.

• The doctor may prescribe nutritional supplements or a particular diet to treat the underlying causes of brain impairment. The doctor may prescribe medications that lower ammonia levels or stop seizures. They could also suggest stopping a drug that the patient has been taking for a long time.

• If the illness is caused by liver or renal difficulties, one may need dialysis or an organ transplant. One may fall into a coma in some circumstances of the disease, such as when the brain does not receive enough oxygen. In such a circumstance, the doctor may decide to place the patient on life support to keep them alive.

Understanding the primary cause of encephalopathy is critical to developing a treatment plan to decrease or eradicate the cause. Static encephalopathy is a kind of encephalopathy that is difficult or impossible to treat in which brain damage or alteration is permanent. Static encephalopathy is best treated by preventing future damage and implementing rehabilitation to let the individual perform at his or her highest functional level as feasible.

Conclusion:

Encephalopathy can be avoided in many circumstances. The key to preventing encephalopathy is to prevent or reduce the risk of having any of the several causes. If encephalopathy develops, treating the underlying cause as soon as possible increases the chances of preventing severe encephalopathy.