Abstract
Hepatic encephalopathy (HE) represents one of the most common events in terminal liver failure. Acute HE (fulminant hepatic failure, FHF) presents with the abrupt onset of delirium, seizures, and coma, and has a mortality rate of about 90%. The principal cause of death in FHF is brain edema associated with increased intracranial pressure. Chronic HE, sometimes referred to as portal-systemic encephalopathy, most often occurs in the setting of cirrhosis and is characterized by change in personality, altered mood and behavior, diminished intellectual capacity, abnormal muscle tone and tremor (asterixis), stupor and coma. For reviews, see (Rothstein and Herlong, 1989; Lockwood. 1992).