Encephalopathy pathophysiology

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Encephalopathy

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

Overview

Pathophysiology

Encephalopathy is a broad term given to lots of condition's which cause dysfunction of brain. There are varied ways of causing encephalopthies.

Brain is protected from the circulatory toxins by blood brain barrier lined by astrocytes. In cases of hepatic failure due to any reason, detoxifying capacity of liver is drastically reduced. This causes increase in concentration of circulatory toxins like ammonia, mercaptans, manganese. Circulatory toxins damage the barrier made by astrocytes and cause pathological changes in the cells. This alters blood brain barrier and toxins gain access into the brain tissues.

Brain needs huge oxygen supply owing to its high metabolic activity. When oxygen is deprived from the brain energy stores of the neuronal cells is decreased rapidly resulting in neuronal injury and encephalopathy.

Normal neuronal activity needs a balanced environment of electrolytes, water and lots of substrates. In case of dehydration and renal diseases causing electrolyte abnormalities this equilibrium is disturbed. This results in dysfunction of brain.

This is disorder of diencephalic brain tissue around the third and fourth ventricle. It results of deficiency of vitamin B1, thiamine. It is the most under recognized cause of encephalopathy in intensive care units. Thiamine is an important co-factor for enzyme required for glucose utilization in brain. If this is deficient it automatically goes to low energy state and performing less than normal.

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