Author information

¹Value Based Care Department, San Francisco Health Network / Zuckerberg San Francisco General Hospital and Trauma Center.

²Division of Gastroenterology and Hepatology, Stanford University School of Medicine; Gastroenterology Section, Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA. Electronic address: rwong123@stanford.edu.

Abstract

Hepatic encephalopathy (HE) can occur as a complication of chronic liver disease as well as acute liver failure. HE is associated with significantly increased morbidity and worse patient outcomes. The clinical manifestation of HE ranges from early less-severe presentations that may only be accurately detected on dedicated psychomotor diagnostic testing to overt alterations in cognition and mental status to the most severe form of coma. Greater awareness of the clinical manifestations of HE across the spectrum of symptom severity is critical for early identification and timely initiation of appropriate therapy to improve patient outcomes.