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Waldemar Brola

NEUROLOGICZNE ASPEKTY ENCEFALOPATII W?TROBOWEJ

NEUROLOGICAL ASPECTS OF HEPATIC ENCEPHALOPATHY

STRESZCZENIE 
W ostrej niewydolno?ci w?troby wywo?anej toksynami, wirusami hepatotropowymi lub lekami oraz w jej chorobach przewlek?ych (marsko??) dochodzi do upo?ledzenia odtruwaj?cej funkcji w?troby. Toksyczne substancje pojawiaj? si? w kr??eniu ogólnym, a nast?pnie docieraj? do mózgu, zaburzaj?c jego funkcj? i powoduj?c objawy neuropsychiatryczne nazywane encefalopati? w?trobow? (EW). Encefalopatia w?trobowa manifestuje si? szerokim spektrum objawów o ró?nym nasileniu ? od dyskretnego pogorszenia funkcji intelektualnych i zaburze? zachowania, przez ró?norodne objawy neurologiczne i narastaj?ce zaburzenia ?wiadomo?ci, a? do ?pi?czki w?trobowej ze sztywno?ci? odmó?d?eniow?.

SUMMARY 
Acute liver failure caused by toxins, hepatotropic viruses or drugs and in the chronic diseases (cirrhosis) may lead to impairment of liver detoxification function. Toxins present in the systemic circulation reach the brain, disrupting its function and causing neuropsychiatric symptoms called hepatic encephalopathy (HE). Hepatic encephalopathy manifests a wide spectrum of symptoms of varying degrees ? from a discrete deterioration in intellectual functioning and behaviour disorders, through a variety of neurological symptoms and progressive disturbance of consciousness, until the hepatic coma with decerebration rigidity. An important problem is the minimal hepatic encephalopathy (MHE), the clinical signs are still absent, but central nervous system dysfunction can be demonstrated sensitive diagnostic methods. Patients with MHE are clearly lower quality of life, significantly impaired function and reduced ability to drive motor vehicles. Early diagnosis offers the chance to take proper and effective treatment, thereby preventing the occurrence of severe neurological symptoms. 
Keys words: hepatic encephalopathy, liver cirrhosis, hepatic coma, neurological complications.