History
The occurrence of disturbed behaviour in people with jaundice may have been described in antiquity by Hippocrates of Cos (ca. 460–370 BCE). Celsus and Galen (first and third century respectively) both recognised the condition. Many modern descriptions of the link between liver disease and neuropsychiatric symptoms were made in the eighteenth and nineteenth century; for instance, Giovanni Battista Morgagni (1682–1771) reported in 1761 that it was a progressive condition.
In the 1950s, several reports enumerated the numerous abnormalities reported previously, and confirmed the previously enunciated theory that metabolic impairment and portosystemic shunting are the underlying mechanism behind hepatic encephalopathy, and that the nitrogen-rich compounds originate from the intestine. Many of these studies were done by Professor Dame Sheila Sherlock (1918–2001), then at the Royal Postgraduate Medical School in London and subsequently at the Royal Free Hospital. The same group investigated protein restriction and neomycin.
The West Haven classification was formulated by Prof Harold Conn and colleagues at Yale University while investigating the therapeutic efficacy of lactulose.
Read more about this topic: Hepatic Encephalopathy
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