In a small proportion of cases, the encephalopathy is caused directly by liver failure; this is more likely in acute liver failure. More commonly, especially in chronic liver disease,<unk>  is triggered by an additional cause, and identifying these triggers can be important to treat the episode effectively. Type Causes Excessivenitrogen load Consumption of large amounts of protein, gastrointestinal bleeding e.g. from esophageal varices (blood is high in protein, which is reabsorbed from the bowel), kidney failure (inability to excrete nitrogen-containing waste products such as urea), constipation Electrolyte ormetabolic disturbance Hyponatraemia (low sodium level in the blood) and hypokalaemia (low potassium levels)—these are both common in those taking diuretics, often used for the treatment of ascites; furthermore alkalosis (decreased acid level), hypoxia (insufficient oxygen levels), dehydration Drugs andmedications Sedatives such as benzodiazepines (often used to suppress alcohol withdrawal or anxiety disorder), narcotics (used as painkillers or drugs of abuse), antipsychotics, alcohol intoxication Infection Pneumonia, urinary tract infection, spontaneous bacterial peritonitis, other infections Others Surgery, progression of the liver disease, additional cause for liver damage (e.g. alcoholic<unk> is,<unk> is A) Unknown In 20–30% of cases, no clear cause for an attack can be found<unk>  may also occur after the creation of a transjugular intrahepatic portosystemic shunt (TIPS). This is used in the treatment of refractory ascites, bleeding from oesophageal varices and hepatorenal syndrome. TIPS-related encephalopathy occurs in about 30% of cases, with the risk being higher in those with previous episodes of encephalopathy, higher age, female sex, and liver disease due to causes other than alcohol.
Hepatic encephalopathy
Hyponatremia
Methanol toxicity
Hypoglycemia
Toxic encephalopathy
Wernicke–Korsakoff syndrome
Hemolytic jaundice
Delirium tremens