Hepatic Encephalopathy
Because of the increasing burden of hepatitis C and fatty liver disease, there is an explosion in the prevalence of chronic liver failure and hence its complications. The onset of Hepatic Encephalopathy (HE) in these patients has a significant impact on t
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Series Editor George Y. Wu University of Connecticut Health Center, Farmington, CT, USA
For further volumes: http://www.springer.com/series/7672
Kevin D. Mullen
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Ravi K. Prakash
Editors
Hepatic Encephalopathy
Editors Kevin D. Mullen, MD, FRCPI Division of Gastroenterology MetroHealth Medical Center Cleveland, OH, USA
Ravi K. Prakash, MD, MRCP Division of Gastroenterology MetroHealth Medical Center Cleveland, OH, USA
ISBN 978-1-61779-835-1 e-ISBN 978-1-61779-836-8 DOI 10.1007/978-1-61779-836-8 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2012936298 © Springer Science+Business Media, LLC 2012 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Humana Press, c/o Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Humana Press is part of Springer Science+Business Media (www.springer.com)
We would like dedicate this book to Sheila Sherlock who had a major interest in hepatic encephalopathy and also inspired many people to join the field of hepatology.
Preface
It is with great pleasure that we write this preface. Relatively few books, especially in recent years, have been published on the topic of “Hepatic Encephalopathy” (HE). Considerable changes have occurred in this field over the last few decades so a comprehensive update is in order. We have called upon virtually all of the leaders in this field to contribute with their colleagues chapters on HE in their specific area of expertise. The first introductory chapter outlines the major changes in nomenclature and classification in the last few decades. Specifically, a new term, Covert HE, has been introduced to replace the less satisfactory term minimal HE. The roles of ammonia, neural inflammation, general inflammation, oxidative stress, and endogenous benzodiazepines in the pathogenesis of HE are discussed by the leading authorities in these areas. This is followed by chapters on the diagnosis of overt and covert (or minimal) HE followed by EEG changes and brain imaging seen in HE. The treatment section features the long-standing no
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