Encephalopathy Classification and external resources
MeSH	D001927

Encephalopathy literally means disease of the brain. Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain In some contexts it refers to permanent brain injury, and in others it is reversible. It can be due to direct injury to the brain, or illness remote from the brain. In medical jargon it can refer to a wide variety of brain disorders with very different etiologies, prognoses and implications. For example, prion diseases, all of which cause transmissible spongiform encephalopathies, are nearly always fatal and have an infectious origin, but other encephalopathies are reversible and can be caused by nutritional deficiencies, toxins, and several other causes. A prion (ˈpriːɒn is thought to be an infectious agent that according to current scientific consensus is comprised entirely of a propagated, mis-folded Transmissible spongiform encephalopathies' ( TSEs, also known as prion diseases) are a group of progressive conditions that affect the Brain and

Contents 1 Types 2 Causes 3 Diagnosis 4 Therapy 5 Prognosis 6 References 7 See also

Types

There are many types of encephalopathy. Some examples include:

• Mitochondrial encephalopathy - Metabolic disorder caused by dysfunction of mitochondrial DNA. Mitochondrial Myopathy, Encephalopathy, Lactic acidosis, stroke-like episodes, abbreviated to MELAS is one of the family of Mitochondrial Can affect many body systems, particularly the brain and nervous system.
• Glycine encephalopathy - A pediatric metabolic disorder
• Hepatic encephalopathy - Arising from advanced cirrhosis of the liver
• Hypoxic ischemic encephalopathy - Permanent or transitory encephalopathy arising from severely reduced oxygen delivery to the brain
• Static encephalopathy - Unchanging, or permanent, brain damage
• Uremic encephalopathy - Arising from high levels of toxins normally cleared by the kidneys -- rare where dialysis is readily available
• Wernicke's encephalopathy - Arising from thiamine deficiency, usually in the setting of alcoholism
• Hashimoto's encephalopathy - Arising from an auto-immune disorder
• Hypertensive encephalopathy - Arising from acutely increased blood pressure
• Toxic-Metabolic encephalopathy - A catch-all for brain dysfunction caused by infection, organ failure, or intoxication. Glycine encephalopathy, also known as non-ketotic hyperglycinemia or NKH, is an Autosomal recessive Metabolic disorder characterized by abnormally Hepatic encephalopathy (sometimes hepatoencephalopathy) is a potentially-reversible Neuropsychiatric abnormality in the setting of Liver failure, whether For other uses of the term "hypoxia" see Hypoxia. Cerebral hypoxia refers to deprivation of Oxygen supply to brain tissue Wernicke encephalopathy is a Syndrome characterised by Ataxia, Ophthalmoplegia, confusion and impairment of Short-term memory. Hashimoto's Encephalopathy is a very rare condition associated with Hashimoto's Thyroiditis. Encephalopathy /ɛnˌsɛfəˈlɒpəθi/ literally means Disease of the Brain.
• Transmissible spongiform encephalopathy - A collection of diseases all caused by prions, and characterized by "spongy" brain tissue (riddled with holes), impaired locomotion or coordination, and a high fatality rate. Transmissible spongiform encephalopathies' ( TSEs, also known as prion diseases) are a group of progressive conditions that affect the Brain and Includes bovine spongiform encephalopathy (mad cow disease), scrapie, and kuru among others. Bovine Spongiform Encephalopathy ( BSE) commonly known as Mad-Cow Disease ( MCD) is a fatal Neurodegenerative disease in Cattle Scrapie is a fatal degenerative Disease that affects the Nervous systems of Sheep and Goats It is one of several Transmissible spongiform Kuru is a disease which affects the Brain. It was endemic among the Fore tribe of Papua New Guinea and was universally fatal

Causes

Encephalopathy alters brain function and/or structure. It may be caused by an infectious agent (bacteria, virus, or prion), metabolic or mitochondrial dysfunction, brain tumor or increased intracranial pressure, exposure to toxins (including solvents, drugs, alcohol, paints, industrial chemicals, and certain metals), radiation, trauma, poor nutrition, or lack of oxygen or blood flow to the brain. The Bacteria ( singular: bacterium) are a large group of unicellular Microorganisms Typically a few Micrometres in length bacteria have A virus (from the Latin virus meaning Toxin or Poison) is a sub-microscopic infectious agent that is unable A prion (ˈpriːɒn is thought to be an infectious agent that according to current scientific consensus is comprised entirely of a propagated, mis-folded Metabolism is the set of Chemical reactions that occur in living Organisms in order to maintain Life. In Cell biology, a mitochondrion (plural mitochondria) is a membrane-enclosed Organelle found in most eukaryotic cells. A brain tumor is any intracranial Tumor created by abnormal and uncontrolled cell division, normally either in the Brain itself ( Neurons Intracranial pressure, ( ICP) is the pressure exerted by the Cranium on the Brain tissue Cerebrospinal fluid (CSF and the brain's circulating In Chemistry, an alcohol is any Organic compound in which a Hydroxyl group ( - O[[hydrogen H]]) is bound to a Carbon Oxygen (from the Greek roots ὀξύς (oxys (acid literally "sharp" from the taste of acids and -γενής (-genēs (producer literally begetteris the

The hallmark of encephalopathy is an altered mental state. Depending on the type and severity of encephalopathy, common neurological symptoms are loss of cognitive ability, subtle personality changes, inability to concentrate, lethargy, and depressed consciousness. Other neurological signs may include myoclonus (involuntary twitching of a muscle or group of muscles), asterixis (abrupt loss of muscle tone, quickly restored), nystagmus (rapid, involuntary eye movement), tremor, seizures, and respiratory abnormalities such as Cheynes-Stokes respiration (cyclic waxing and waning of tidal volume) and post-hypercapnic apnea. Myoclonus (maɪˈɒklənəs is brief involuntary twitching of a Muscle or a group of muscles Asterixis (also called the flapping tremor) is a Tremor of the wrist when the wrist is extended (dorsiflexion sometimes said to resemble a bird flapping its wings Nystagmus is a type of eye movement characterized by alternating slow phase movements in one direction and Saccade -like quick phases in the other direction An epileptic seizure is caused by excessive and/or hypersynchronous electrical Neuronal activity and is usually self-limiting

Diagnosis

Blood tests, spinal fluid examination by lumbar puncture, imaging studies, electroencephalograms and similar diagnostic studies may be used to differentiate the various causes of encephalopathy. A blood test is a laboratory analysis performed on a Blood sample that is usually extracted from a Vein in the arm using a needle, or via In Medicine, a lumbar puncture (colloquially known as a spinal tap) is a Diagnostic and at times therapeutic procedure that is performed in order

Diagnosis is frequently clinical. That is, no set of tests give the diagnosis, but the entire presentation of the illness with nonspecific test results informs the experienced clinician of the diagnosis.

Therapy

Treatment varies according to the type and severity of the encephalopathy. Anticonvulsants may be prescribed to reduce or halt any seizures. The anticonvulsants, also called antiepileptic drugs (abbreviated "AEDs" are a diverse group of pharmaceuticals used in the treatment of epileptic Changes to diet and nutritional supplements may help some patients. In severe cases, dialysis or organ replacement surgery may be needed.

Prognosis

Treating the underlying cause of the disorder may improve or reverse symptoms. However, in some cases, the encephalopathy may cause permanent structural changes and irreversible damage to the brain. Some encephalopathies can be fatal.

References

• Adapted from http://www.ninds.nih.gov/disorders/encephalopathy/encephalopathy.htm

The Diagnosis of Stupor and Coma by Plum and Posner ISBN 0195138988 remains one the of best detailed observational references to the condition

See also

• Brain damage
• Neurobiology
• Neurobiological brain disorder

Brain damage, or Acquired brain injury, is the destruction or degeneration of Brain cells. Neurobiology is the study of cells of the Nervous system and the organization of these cells into functional circuits that process information and mediate behavior Mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as

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