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Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 642108, 7 pages
http://dx.doi.org/10.1155/2012/642108
Review Article

Pathogenesis of Hepatic Encephalopathy

1Department of Gastroenterology, Hepatology and Infectious Diseases, Jagiellonian University Medical College, Sniadeckich Street 5, 31-531 Krakow, Poland
2Department of Neurology, Jagiellonian University Medical College, Sniadeckich Street 5, 31-531 Krakow, Poland

Received 14 October 2012; Revised 16 November 2012; Accepted 16 November 2012

Academic Editor: Sergio Morini

Copyright © 2012 Irena Ciećko-Michalska et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hepatic encephalopathy can be a serious complication of acute liver failure and chronic liver diseases, predominantly liver cirrhosis. Hyperammonemia plays the most important role in the pathogenesis of hepatic encephalopathy. The brain-blood barrier disturbances, changes in neurotransmission, neuroinflammation, oxidative stress, GABA-ergic or benzodiazepine pathway abnormalities, manganese neurotoxicity, brain energetic disturbances, and brain blood flow abnormalities are considered to be involved in the development of hepatic encephalopathy. The influence of small intestine bacterial overgrowth (SIBO) on the induction of minimal hepatic encephalopathy is recently emphasized. The aim of this paper is to present the current views on the pathogenesis of hepatic encephalopathy.