Encephalopathy

Your brain function is altered when it’s injured due to an accident, infection or disease. Encephalopathy is a term for this serious neurological change. The condition commonly causes an altered mental state including memory loss or personality changes.

Encephalopathy can affect anyone, especially those with head trauma, birth complications and certain medical conditions. There are several types of encephalopathy that can cause temporary or permanent brain damage.

Depending on the type and your unique situation, it may take time to fully heal from these types of brain injuries. Our dedicated and experienced team of neurologists are here to guide you through your diagnosis and treatment process.

What is encephalopathy?

Any type of disorder, disease or damage that affects your brain’s function or structure is referred to as encephalopathy. Damage to your brain occurs when the flow of oxygen or blood is restricted.

The type of encephalopathy is determined by the cause of the brain damage. Encephalopathy complications can be irreversible and may lead to long-term and life-altering complications including a coma.

Types of encephalopathy

Causes and risk factors for encephalopathy are determined by the type. Infections of the brain such as meningitis, brain tumors and long-term exposure to toxins such as drugs, radiation and industrial chemicals are common risk factors.

Encephalopathy types are categorized by if the damage is reversible or irreversible. The most common types are irreversible anoxic encephalopathy and chronic traumatic encephalopathy.

Types of reversible encephalopathy

• Hepatic encephalopathy: Occurs when your liver function decreases, allowing toxins to build up in your blood. This impacts your brain function. Liver dysfunction, including chronic liver disease, can cause this type of brain damage. Alcohol use disorder, overdosing on acetaminophen and a high level of proteins in your diet can lead to liver conditions.
• Hashimoto’s encephalopathy: This type occurs when your system isn't functioning normally due to thyroid problems. When this happens, your immune system may attack your brain function. It’s linked to an autoimmune disease called Hashimoto’s disease that impacts your thyroid function.
• Metabolic encephalopathy: If you have an underlying condition that affects your metabolism, such as diabetes, liver disease or kidney failure, your brain function may be impacted. A common example of metabolic encephalopathy is if you have diabetes and your blood sugar gets too high, leading to confusion or even a coma.
• Toxic encephalopathy: Occurs when there’s long-term exposure to drugs and medications such as painkillers or antibiotics. This type is also caused by exposure to poisons.
• Uremic encephalopathy: Similar to toxic encephalopathy, this type is caused by an accumulation of toxins from acute or chronic kidney failure. It can also happen due to blood loss, dehydration and infection.
• Wernicke encephalopathy: Also known as Wernicke-Korsakoff syndrome, this memory disorder is caused by a lack of thiamin or vitamin B1. This can occur with alcohol use disorder and malnutrition.

Irreversible encephalopathy types

• Anoxic encephalopathy: Also known as a hypoxic-ischemic brain injury, this type of brain damage is caused by the loss of oxygen and circulation to your brain. Many things can lead to this, including cardiac arrest, a serious asthma attack, seizure, choking, near drowning or a blunt force injury to your head.
• Chronic traumatic encephalopathy (CTE): Common among professional athletes, this type of brain damage occurs from repeated impacts and injuries to your head.

How does encephalopathy differ from encephalitis?

With similar names and symptoms, these neurological conditions are often confused. While encephalopathy has many causes, encephalitis is caused by the brain itself being inflamed. Encephalitis can eventually cause encephalopathy.

Encephalopathy symptoms

In order to receive proper treatment and minimize long-term complications, it’s vital to recognize the symptoms of encephalopathy. The most common symptom of encephalopathy is a change in your personality. Additional symptoms depend on the type of brain damage and if you have an acute (severe) case of encephalopathy.

Common symptoms include:

• Confusion
• Behavior changes
• Memory loss
• Hallucinations
• Loss of consciousness

Acute symptoms include:

• Coma
• Seizures
• Involuntary muscle movements
• Dementia
• Tremors

Diagnosing encephalopathy

To diagnose encephalopathy, a series of tests and exams will be ordered. First, your provider will start with a physical exam and discuss your medical history and medications. A neurological exam will follow to check your brain and nervous system function.

Labs and imaging may be ordered to provide insight and rule out any other possible related conditions. Potential tests include:

• CT scan: This is a noninvasive test that uses special X-ray equipment that captures many cross-sectional views of an organ or area being examined. A computer then combines the many slices to create a two-dimensional view of the organ, tissue or blood vessel for examination.
• MRI: This imaging test combines a powerful magnetic field, radio waves and a computer to create highly detailed images of the brain and other organs or body structures and their functions.
• Blood tests: A blood sample and test measures abnormal levels that may indicate the source of the brain damage.
• Electroencephalogram (EEG): This test monitors brain wave activity during seizure and non-seizure periods.
• Lumbar puncture: Also known as a spinal tap, a lumbar puncture can diagnose diseases of the central nervous system, including the brain.

Encephalopathy treatment options

It's important to remember that recovery from a brain injury takes time. Your individualized treatment plan will depend on your type of encephalopathy, if it’s reversible or not, and your symptoms. You’ll also have to manage and monitor any underlying conditions that caused the brain damage.

Treatment may include:

• Surgery
• Medications
• Neuroscience physical therapy

In some acute cases of encephalopathy, emergency surgery, organ transplant or life support will be needed.