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{{Hepatic encephalopathy}}
{{Hepatic encephalopathy}}
{{CMG}};{{AE}}{{MMJ}}
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'''wikipedia''':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 (1925–2011) and colleagues at Yale University while investigating the therapeutic efficacy of lactulose.


== Overview ==
== Overview ==
Hepatic encephalopathy was first discovered by G.B. Morgagni, an italian [[anatomist]], in the 18th century who described a case of hepatic encephalopathy. Friedrich Theodor Von Frerichs, in the 19th century clearly reported the existence of episodes of [[delirium]], [[somnolence]] and [[coma]] in [[Liver diseases|liver disease]] in his famous treatise on [[Liver diseases|liver disease]]. In 1954''',''' Dame Sheila Patricia Violet Sherlock and her disciples in London gave a detailed description of the clinical findings, the [[pathophysiology]] and treatment of hepatic encephalopathy. For the first time, she confirmed the role of [[Hyperammonemia|hyperammonaemia]] in the [[pathophysiology]] of the hepatic encephalopathy and the role of [[gut]] [[microbes]] which could be modulated by [[antibiotics]] to revert [[coma]].


== Historical Perspective ==
== Historical Perspective ==


=== Discovery ===
=== Discovery ===
* [Disease name] was first discovered by '''GB. Morgagni''', an italian anatomist, in the 18th century who described a case of hepatic encephalopathy. He reported the history of a noble from Venice who was an alcohol misuser in the past. The patient first developed ascites and some episodes of agitation, and then he developed prolonged episodes of somnolence and delirium.<ref name="pmid26041956">{{cite journal| author=Amodio P| title=Hepatic encephalopathy: historical remarks. | journal=J Clin Exp Hepatol | year= 2015 | volume= 5 | issue= Suppl 1 | pages= S4-6 | pmid=26041956 | doi=10.1016/j.jceh.2014.12.005 | pmc=4442853 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26041956  }} </ref>
* In 18th century, G.B. Morgagni, an italian [[anatomist]], was the first to discover and describe a case of hepatic encephalopathy.<ref name="pmid26041956">{{cite journal| author=Amodio P| title=Hepatic encephalopathy: historical remarks. | journal=J Clin Exp Hepatol | year= 2015 | volume= 5 | issue= Suppl 1 | pages= S4-6 | pmid=26041956 | doi=10.1016/j.jceh.2014.12.005 | pmc=4442853 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26041956  }} </ref>
* '''Friedrich Theodor von Frerichs''', in the 19th century clearly reported the existence of episodes of delirium, somnolence and coma in liver disease in his famous treatise on liver disease.<ref name="pmid26041956">{{cite journal| author=Amodio P| title=Hepatic encephalopathy: historical remarks. | journal=J Clin Exp Hepatol | year= 2015 | volume= 5 | issue= Suppl 1 | pages= S4-6 | pmid=26041956 | doi=10.1016/j.jceh.2014.12.005 | pmc=4442853 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26041956  }} </ref>
* In the 19th century, Friedrich Theodor Von Frerichs for the first time reported the existence of episodes of [[delirium]], [[somnolence]] and [[coma]] in [[Liver diseases|liver disease]] in his famous treatise on [[Liver diseases|liver disease]].<ref name="pmid26041956">{{cite journal| author=Amodio P| title=Hepatic encephalopathy: historical remarks. | journal=J Clin Exp Hepatol | year= 2015 | volume= 5 | issue= Suppl 1 | pages= S4-6 | pmid=26041956 | doi=10.1016/j.jceh.2014.12.005 | pmc=4442853 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26041956  }} </ref>
* In 1954''', Dame Sheila Patricia Violet Sherlock''' and her disciples in London gave a definite improvement in the description of the clinical findings, the pathophysiology and treatment of hepatic encephalopathy. For the first time she confirmed the role of hyperammonaemia in the pathophysiology of the hepatic encephalopathy and the role of gut microbiota that could be modulated by antibiotics to revert coma.<ref name="pmid13193045">{{cite journal| author=SHERLOCK S, SUMMERSKILL WH, WHITE LP, PHEAR EA| title=Portal-systemic encephalopathy; neurological complications of liver disease. | journal=Lancet | year= 1954 | volume= 267 | issue= 6836 | pages= 454-7 | pmid=13193045 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13193045  }} </ref>
* In 1954''',''' Dame Sheila Patricia Violet Sherlock and her disciples in London gave a deatiled description of the clinical findings, the [[pathophysiology]] and treatment of hepatic encephalopathy.
* For the first time, she also confirmed the role of [[Hyperammonemia|hyperammonaemia]] in the [[pathophysiology]] of the hepatic encephalopathy and the role of gut [[microbes]], that could be modulated by [[antibiotics]] to revert [[coma]].<ref name="pmid13193045">{{cite journal| author=SHERLOCK S, SUMMERSKILL WH, WHITE LP, PHEAR EA| title=Portal-systemic encephalopathy; neurological complications of liver disease. | journal=Lancet | year= 1954 | volume= 267 | issue= 6836 | pages= 454-7 | pmid=13193045 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13193045  }} </ref>


== Landmark Events in the Development of Treatment Strategies ==
== Landmark Events in the Development of Treatment Strategies ==
* In 1954''', Dame Sheila Patricia Violet Sherlock''' and her disciples in London gave a definite improvement in the description of the treatment of hepatic encephalopathy.<ref name="pmid13193045">{{cite journal| author=SHERLOCK S, SUMMERSKILL WH, WHITE LP, PHEAR EA| title=Portal-systemic encephalopathy; neurological complications of liver disease. | journal=Lancet | year= 1954 | volume= 267 | issue= 6836 | pages= 454-7 | pmid=13193045 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13193045  }} </ref>
* In 1954''',''' Dame Sheila Patricia Violet Sherlock and her disciples published a detailed description of the treatment of hepatic encephalopathy.<ref name="pmid13193045">{{cite journal| author=SHERLOCK S, SUMMERSKILL WH, WHITE LP, PHEAR EA| title=Portal-systemic encephalopathy; neurological complications of liver disease. | journal=Lancet | year= 1954 | volume= 267 | issue= 6836 | pages= 454-7 | pmid=13193045 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13193045  }} </ref>


==References==
==References==

Latest revision as of 15:08, 24 January 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Hepatic encephalopathy was first discovered by G.B. Morgagni, an italian anatomist, in the 18th century who described a case of hepatic encephalopathy. Friedrich Theodor Von Frerichs, in the 19th century clearly reported the existence of episodes of delirium, somnolence and coma in liver disease in his famous treatise on liver disease. In 1954, Dame Sheila Patricia Violet Sherlock and her disciples in London gave a detailed description of the clinical findings, the pathophysiology and treatment of hepatic encephalopathy. For the first time, she confirmed the role of hyperammonaemia in the pathophysiology of the hepatic encephalopathy and the role of gut microbes which could be modulated by antibiotics to revert coma.

Historical Perspective

Discovery

  • In 18th century, G.B. Morgagni, an italian anatomist, was the first to discover and describe a case of hepatic encephalopathy.[1]
  • In the 19th century, Friedrich Theodor Von Frerichs for the first time reported the existence of episodes of delirium, somnolence and coma in liver disease in his famous treatise on liver disease.[1]
  • In 1954, Dame Sheila Patricia Violet Sherlock and her disciples in London gave a deatiled description of the clinical findings, the pathophysiology and treatment of hepatic encephalopathy.
  • For the first time, she also confirmed the role of hyperammonaemia in the pathophysiology of the hepatic encephalopathy and the role of gut microbes, that could be modulated by antibiotics to revert coma.[2]

Landmark Events in the Development of Treatment Strategies

  • In 1954, Dame Sheila Patricia Violet Sherlock and her disciples published a detailed description of the treatment of hepatic encephalopathy.[2]

References

  1. 1.0 1.1 Amodio P (2015). "Hepatic encephalopathy: historical remarks". J Clin Exp Hepatol. 5 (Suppl 1): S4–6. doi:10.1016/j.jceh.2014.12.005. PMC 4442853. PMID 26041956.
  2. 2.0 2.1 SHERLOCK S, SUMMERSKILL WH, WHITE LP, PHEAR EA (1954). "Portal-systemic encephalopathy; neurological complications of liver disease". Lancet. 267 (6836): 454–7. PMID 13193045.

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