Comprehensive Insights into hepatic encephalopathy pathophysiology, epidemiology, diagnosis and management

Document Type : Review Article

Authors

1 Department of Pharmacology and Toxicology, Faculty of Pharmacy, Egyptian Russian University, Cairo, Egypt

2 Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt

3 toxicology and pharmacology department, faculty of pharmacy , ain ahms university

4 pharmacology and toxicology department, faculty of pharmacy, Ain shams university

Abstract

Hepatic encephalopathy (HE) is a prevalent and potentially fatal complication arising from both chronic liver disease and acute liver failure, significantly impacting patient outcomes. This condition encompasses a wide spectrum of neuropsychiatric disorders, ranging from mild cognitive impairment to severe manifestations such as disorientation, confusion, and even coma. The clinical implications of HE are profound, as it not only contributes to increased morbidity and mortality rates but also imposes a substantial economic burden on healthcare systems due to frequent hospitalizations and prolonged treatment courses. This review aims to provide a comprehensive analysis of the latest classifications of HE, elucidating the underlying mechanisms and physiological processes that lead to neurological deterioration in patients with advanced liver disease. Furthermore, it will explore current diagnostic methodologies and management strategies, including established therapeutic options such as lactulose and rifaximin, as well as emerging treatment modalities that show promise in improving patient outcomes. By synthesizing recent findings and clinical practices, this article seeks to enhance understanding of HE and inform future research directions aimed at optimizing care for affected individuals.

Keywords

Archives of Pharmaceutical Sciences Ain Shams University
Volume 9, Issue 2
Special issue in Pharmacology and Toxicology: Innovative Pharmacological Interventions for Different Diseases
October 2025
Pages 254-275

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