Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem may occur suddenly or it may develop slowly over time.
An important function of the liver is to make toxic substances in the body harmless. These substances may be made by the body (ammonia), or substances that you take in (medicines).
When the liver is damaged, these “poisons” can build up in the bloodstream and affect the function of the nervous system. The result may be HE.
HE can occur suddenly and you may become ill very quickly. Causes of HE may include:
- Hepatitis A or B infection (uncommon to occur this way)
- Blockage of blood supply to the liver
- Poisoning by different toxins or medicines
- Upper gastrointestinal bleeding
People with severe liver damage often suffer from HE. The end result of chronic liver damage is cirrhosis. Common causes of chronic liver disease are:
- Severe hepatitis B or C infection
- Alcohol abuse
- Autoimmune hepatitis
- Bile duct disorders
- Some medicines
- Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)
Once you have liver damage, episodes of worsening brain function may be triggered by:
- Less body fluids (dehydration)
- Eating too much protein
- Low potassium or sodium levels
- Bleeding from the intestines, stomach, or food pipe (esophagus)
- Kidney problems
- Low oxygen levels in the body
- Shunt placement or complications
- Narcotic pain or sedative medicines
Disorders that can appear similar to HE may include:
- Alcohol intoxication
- Alcohol withdrawal
- Bleeding under the skull
- Brain disorder caused by lack of vitamin B1
In some cases, HE is a short-term problem that can be corrected. It may also occur as part of a long-term (chronic) problem from liver disease that gets worse over time.
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