HomeHealth articleswernicke's encephalopathyWhat Is Encephalopathy?

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

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Encephalopathy is a term that refers to any abnormality in brain function or structure. Continue reading the article below to learn more about this.

Written by

Dr. Shikha

Medically reviewed by

Dr. Seyedaidin Sajedi

Published At September 13, 2022
Reviewed AtJanuary 19, 2024

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.


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.

Frequently Asked Questions


What Drugs Can Cause Encephalopathy?

Multiple drugs can lead to encephalopathy; some medicines include opioid analgesics, anticonvulsants, sedatives, neuroleptics, and antidepressants. This type of encephalopathy is called drug-induced encephalopathy. In this condition, the patient may experience brain dysfunction, such as cognitive dysfunction, convulsions, abnormal mental behavior, and loss of consciousness.


What Are the Diagnostic Tests for Encephalopathy?

Various tests can be done to confirm the diagnosis, such as -
- CBC or complete blood count. Blood tests help identify diseases, viruses, poisons, and hormonal or chemical imbalances.
- Computed tomography (CT) or magnetic resonance imaging (MRI) scans.
- Metabolic tests such as blood glucose levels, ammonia, electrolytes, oxygen, and liver enzyme levels in the blood.
- Electroencephalograms or EEGs capture brain electrical activity.


What Is the Treatment for Encephalopathy?

The treatment of encephalopathy depends upon the causative factor and mainly involves the management of the symptoms. Therefore in patients experiencing seizures, anticonvulsants can be prescribed. In severe conditions, dialysis or surgery might be needed. Changes in diet and nutritional supplements can also help with this condition. The aim is to treat the underlying disease which helps in improving the overall condition of the patient.


What Are the Risk Factors of Encephalopathy?

Any person can develop encephalopathy, and some of the risk factors of this condition include -
- Age (young children and older adults).
- Weakened immune system.
- Commonly seen in summer.
- Smoking.
- Autoimmune disorders.


What Medication Can Be Used in Encephalopathy?

Encephalitis that is caused by certain viruses can be treated by taking antiviral drugs such as Acyclovir, Ganciclovir, and Foscarnet. The medication usually depends upon the type of the causative organism. Moreover, more managing symptoms like seizures anticonvulsants can also be given.


What Are the Different Stages of Encephalopathy?

The severity of encephalopathy can be classified into the following stages -
Stage 0 - Minimal hepatic encephalopathy. Slight changes in memory and concentration.
Stage 1 - Mild hepatic encephalopathy. Mood changes and sleep problems.
Stage 2 - Moderate hepatic encephalopathy. Inappropriate behavior, slurred speech, trouble doing basic math.
Stage 3 - Severe hepatic encephalopathy. Disorientation, extreme sleepiness, or anxiety.
Stage 4 - Coma.


Which Antibiotics Can Cause Encephalopathy?

Encephalopathy caused by certain antibiotics is also called antibiotic-associated encephalopathy (AAE). It can be divided into three types according to the antibiotics -
- Encephalopathy accompanied by seizures seen after the administration of Cephalosporins and Penicillin.
- Encephalopathy characterized by psychosis seen within days of administration of antibiotics such as Quinolones, Macrolides, and Procaine penicillin.
- Encephalopathy with cerebellar signs and MRI abnormalities caused by Metronidazole.


Can Encephalopathy Cause Brain Damage?

Encephalopathy is a brain condition causing inflammation of the brain. Various things, such as viral infections, autoimmune infections, bacterial infections, insect bites, and others can cause this. Without any treatment, this condition may lead to permanent morphological changes and damage to the brain.


What Viruses Can Cause Encephalopathy?

Encephalopathy caused by viruses is called viral encephalopathy. This is mainly caused by viruses such as the herpes simplex virus, which can lead to cold sores and is contagious. Other than that, the varicella-zoster virus can cause chickenpox and shingles. In these conditions, patients have to follow antiviral therapy to manage the condition.


Is Encephalopathy Curable?

Encephalopathy can be cured easily with the help of certain medications and surgery in severe cases. Most of the patients fully recover; however, this can take some time. In some cases, even after complete recovery, patients are left with long-term permanent damage to their brains.


What Is the Initial Treatment for Encephalopathy?

In the initial encephalopathy stage, bed rest and plenty of fluids are advised. Certain medications like anti-inflammatory medicines such as Acetaminophen, Ibuprofen, and naproxen sodium can also be prescribed to treat headaches and fever. In severe cases, surgeries may be advised.


Which Antibiotics Are Best for Brain Infections?

Depending upon the causative agent, brain infections are usually treated with anti-fungal or antibiotics. The antibiotics such as Ceftriaxone or Cefotaxime plus Metronidazole are generally advised in the initial stage in case of brain abscesses. If bacteroid species are suspected, Vancomycin can also be added.


What Is the Mortality Rate of Encephalopathy?

Encephalopathy can also lead to death in some instances, whether they are severe or where treatment is delayed. The cause of death is usually severe inflammation of the brain. This has been found in 10 percent of patients with encephalopathy. However, even survivors may have permanent problems such as fatigue, irritability, impaired concentration, seizures, hearing loss, and memory loss.


Is Encephalopathy Contagious?

Certain bacteria, fungi, or viruses can cause encephalopathy. Therefore, it is an infection, and medications must be taken to treat this condition. But it does not spread like other viral infections. However, patients have to get these infections from someone else, which might lead to encephalopathy.


How to Prevent Encephalopathy?

Encephalopathy can be prevented by following specific instructions such as -
- Avoid alcohol.
- Avoid medications such as sleeping pills and antidepressants. 
- Take a nutritious diet, exercise regularly, and maintain a healthy weight. 
Dr. Seyedaidin Sajedi
Dr. Seyedaidin Sajedi



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