Table of Contents
ISRN Hepatology
Volume 2014, Article ID 236268, 16 pages
Review Article

Hepatic Encephalopathy: From the Pathogenesis to the New Treatments

1Departamento de Hepatología, Hospital Vall d’Hebron, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
2Departamento de Medicina Interna, Universidad Autónoma de Barcelona, Spain
3CIBERehd, Instituto de Salud Carlos III, Madrid, Spain

Received 20 November 2013; Accepted 28 January 2014; Published 4 June 2014

Academic Editors: L.-T. Huang, Y. Shimizu, and M.-H. Zheng

Copyright © 2014 Juan Cordoba. 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.


Hepatic encephalopathy is a frequent and serious complication of liver cirrhosis; the pathophysiology of this complication is not fully understood although great efforts have been made during the last years. There are few prospective studies on the epidemiology of this complication; however, it is known that it confers with high short-term mortality. Hepatic encephalopathy has been classified into different groups depending on the degree of hepatic dysfunction, the presence of portal-systemic shunts, and the number of episodes. Due to the large clinical spectra of overt EH and the complexity of cirrhotic patients, it is very difficult to perform quality clinical trials for assessing the efficacy of the treatments proposed. The physiopathology, clinical manifestation, and the treatment of HE is a challenge because of the multiple factors that converge and coexist in an episode of overt HE.