What is encephalopathy?

Encephalopathy refers to the group of symptoms that you experience when your whole brain is not functioning normally.

What are the symptoms of encephalopathy?

The symptoms of encephalopathy vary between people.

The most common symptom of encephalopathy is a change in mental state, with problems such as:

• loss of memory
• difficulty concentrating
• drowsiness
• changes in personality
• confusion

Some people might have:

• jerky eye movements
• poor balance
• difficulty coordinating muscle movements
• involuntary muscle twitching or tremors
• reduced level of consciousness or become unconscious
• seizures
• dementia

What causes encephalopathy?

Encephalopathy can be caused by many conditions including:

• infections
• some medicines
• diabetic ketoacidosis
• kidney failure
• cancer
• autoimmune conditions
• poisoning

Regardless of the cause, sedative medicines, such as sleeping tablets, can make the symptoms worse.

Types of encephalopathy

There are many types of encephalopathy, including:

• hepatic encephalopathy — when the liver doesn’t work properly and can’t remove toxic (poisonous) substances, ammonia builds up to disturb the functioning of the brain.
• chronic traumatic encephalopathy (CTE) — is caused by repeated head knocks and concussions. It is associated with contact sports, such as boxing and football, but can also result from non-sporting situations.
• hypoxic-ischaemic encephalopathy — a lack of oxygen to your baby’s brain around the time of birth leads to abnormal brain function.
• Wernicke encephalopathy — a severe deficiency thiamine can lead to permanent brain damage. It occurs most commonly in people with severe alcohol addiction.

When should I call an ambulance or go to a hospital emergency department?

Go directly to your local hospital emergency department, or call triple zero (000) and ask for an ambulance, if someone you are with is:

• experiencing severe confusion
• having uncontrolled seizures
• losing consciousness

When should I see my doctor?

If you, or someone you know, notices any new problems that might be symptoms of encephalopathy, call your doctor. This is especially important if you have an underlying problem, such as liver disease, because encephalopathy can become an emergency.

How is encephalopathy diagnosed?

Encephalopathy is diagnosed based on your symptoms.

To work out if you have encephalopathy, and what might be causing it, your doctor might:

• talk to you about your symptoms
• speak to your friends or family about any recent behaviour changes
• examine you
• refer you for blood tests
• refer you for imaging scans, such as CT or MRI scan

How is encephalopathy treated?

People with a new, sudden encephalopathy usually need to be treated in hospital. Treatment can include:

• addressing the causes — for example, thiamine supplements might be used for people with Wernicke encephalopathy
• treating the symptoms — for example, anticonvulsants may be prescribed to manage seizures

People with underlying chronic disorders, such as liver disease, are more likely to have repeated episodes of encephalopathy that may need ongoing treatment.

Resources and support

The Queensland Government provides an information sheet about:

• hepatic encephalopathy
• hypoxic ischaemic encephalopathy

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.