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Medical News Today: What to know about encephalopathy

Encephalopathy means brain disease, disorder, or damage. The term refers to temporary or permanent conditions that affect the brain’s structure or function.

The main symptom of encephalopathy is a change to a person’s mental state.

There are different types of encephalopathy, with distinct causes, and encephalopathy can be a complication of another condition.

This article discusses types, causes, and symptoms. It also discusses how doctors can treat encephalopathy.

Causes and types of encephalopathy

Doctor pointing at brain scans on screen showing encephalopathy
Encephalopathy is when the brain changes due to damage, disease, or a disorder.

The word encephalopathy can refer to all kinds of brain damage and diseases.

There are many types of encephalopathy, and they can be grouped by their cause.

Broadly, encephalopathy can arise from physical injury, infection, or other medical conditions.

Below, we explore the types of encephalopathy and their causes:

Physical injury

When encephalopathy results from repeated trauma, it is called chronic traumatic encephalopathy.

Trauma to the head may lead to nerve damage that affects brain function. Chronic traumatic encephalopathy can develop following multiple brain traumas or injuries over time. These may result from a series of accidents or blows to the head.

People in the military or who play contact sports may have a higher risk of chronic traumatic encephalopathy.

Toxins

If toxins build up in the blood and reach the brain, they can cause damage. This may result from an underlying condition, infection, or exposure to toxic chemicals.

There are three types of encephalopathy linked with toxins:

  • Uremic encephalopathy: This results from uremic toxins building up in the blood when a person has kidney failure.
  • Hepatic encephalopathy: This happens if liver disease causes toxins to build up in a person’s blood.
  • Toxic metabolic encephalopathy: This occurs when toxic chemicals, or a chemical imbalance caused by an infection, affects brain function.

High blood pressure

If a person does not receive treatment for high blood pressure, it can lead to swelling in the brain. When this results in a brain injury, it is called hypertensive encephalopathy.

Lack of oxygen

If the brain does not get enough oxygen, a person may experience brain damage. Encephalopathy caused in this way is called hypoxic ischemic encephalopathy.

Vitamin B-1 deficiency

When a person has a vitamin B-1 deficiency, they can develop a type of brain disease called Wernicke encephalopathy.

Vitamin B-1 deficiency may result from:

  • alcohol use disorder
  • malnutrition
  • problems absorbing food in the gut

Prion diseases

Infectious encephalopathy can be the most serious type. It sometimes results from a rare group of conditions called prion diseases or transmissible spongiform encephalopathies.

These progressive diseases are linked to the mutation of a protein called prion.

Prion diseases are neurogenerative. This means that they damage the brain and cause the brain’s function to get worse, or deteriorate, over time. The main feature of prion disease is tiny holes in the brain that give it a spongy appearance.

Examples of prion diseases that can lead to infectious encephalopathy include:

Inherited conditions

Some types of encephalopathy are related to genetics, and a person is more likely to develop one if a family member has it.

Two inherited forms of encephalopathy are:

  • Hashimoto’s encephalopathy: This relates to an autoimmune disease called Hashimoto’s disease, which affects the thyroid. The exact cause of Hashimoto’s is unknown, but doctors believe that it is inherited.
  • Glycine encephalopathy: This occurs when there is too much of the amino acid glycine in the brain. It can affect brain function.

Encephalopathy vs. encephalitis

Encephalopathy and encephalitis both affect the brain, but there are significant differences.

Encephalitis refers to inflammation in the brain, which often results from a viral infection.

Encephalopathy refers to permanent or temporary brain damage, disorder, or disease. It affects the brain’s function or structure and may be degenerative.

Symptoms of encephalopathy

Tired and fatigued person looking at tablet
Fatigue, difficulty concentrating, and forgetfulness are potential symptoms of encephalopathy.

The main symptom of encephalopathy is an altered mental state. This can involve:

  • having trouble staying alert
  • having problems thinking or processing information
  • feeling confused
  • forgetting things
  • behaving out of character
  • finding it hard to concentrate
  • feeling very tired

These symptoms may get worse over time. The progression depends on the type of encephalopathy and how severe it is.

In addition to an altered mental state, a person with encephalopathy may experience:

  • involuntary muscle twitching
  • involuntary eye movements
  • shaking
  • muscle weakness
  • trouble swallowing or speaking
  • seizures

Diagnosis

If a person has symptoms of encephalopathy, they should see a doctor immediately.

The doctor may use the following to reach a diagnosis:

  • blood tests
  • a spinal fluid examination
  • imaging studies, such as MRI or CT scans
  • electroencephalograms, which is a method of recording the electrical activity of the brain

The results of these tests will help the doctor determine:

  • if a person has encephalopathy
  • what type of encephalopathy a person has
  • what the underlying cause is

Treatments

A doctor may recommend surgery to treat encephalopathy.
A doctor may recommend surgery to treat encephalopathy.

Once a doctor has determined the cause of a person’s encephalopathy, they can recommend the best treatment.

The doctor may suggest various medications to slow the progression of the damage.

In some cases, people may require surgery. If a person is having seizures, the doctor may prescribe anticonvulsant drugs.

Complications

Severe encephalopathy may lead to loss of consciousness or coma. If this happens, the doctor will put the person on life support to help them recover.

In rare cases, encephalopathy may lead to permanent brain damage or loss of life.

Prevention

Not all forms of encephalopathy are preventable. However, a person may be able to lower their risk by:

  • eating a healthful, balanced diet
  • reducing alcohol consumption
  • avoiding exposure to toxic chemicals

Outlook

Encephalopathy refers to a broad range of conditions that affect the brain’s function, including brain damage and disease. The primary symptom is an altered mental status.

Doctors can often treat encephalopathy, and many people make a full recovery. With treatment, impaired brain function may be reversed.

However, certain types of encephalopathy are life-threatening. Infectious encephalopathy caused by prion disease is an example of this.

According to the Centers for Disease Control and Prevention (CDC), prion diseases are rare, but they always lead to loss of life. Research into treatments is ongoing.

When they are severe, all types of encephalopathy can be life-threatening.

Some people with severe encephalopathy may develop permanent brain damage. If this happens, the doctor will support the person and their family and help them manage the condition.

A doctor can provide detailed information about an individual’s outlook. In some cases, family members can consult with the doctor on the person’s behalf.

Source: MedicalNewToday.com