Encephalopathy: Types, Causes, Symptoms, Diagnosis, Treatment, Prevention and Outlook

It is a general term that describes a disease that affects the function or structure of the brain.

There are many types of encephalopathy and brain disease . Some types are permanent and some are temporary. Some types are present from birth and never change, while others are acquired after birth and can get progressively worse.

What are the types and causes of encephalopathy?

The following are some main types of encephalopathy, along with their causes:

Chronic traumatic encephalopathy

This type of encephalopathy occurs when there are multiple traumas or injuries to the brain. These blows to the head cause nerve damage in the brain. It is usually found in boxers, soccer players, or members of the military who have been injured in explosions.

Glycine encephalopathy

Glycine encephalopathy is a genetic or inherited condition in which there are abnormally high levels of glycine (an amino acid) in the brain. Symptoms of glycine encephalopathy usually appear in babies shortly after birth.

Hashimoto’s encephalopathy

This is a rare type of encephalopathy that is related to an autoimmune disease known as Hashimoto’s disease.

In Hashimoto’s disease, your immune system mistakenly attacks your thyroid gland . Your thyroid gland is responsible for producing many of your body’s regulatory hormones. Scientists don’t yet know exactly how the two conditions are related.

Hepatic encephalopathy

Hepatic encephalopathy is the result of liver disease. When your liver is not working properly, the toxins that your liver generally extracts from your body can build up in your blood and eventually reach your brain.

hypertensive encephalopathy

Hypertensive encephalopathy is the result of severely high blood pressure that is not treated for too long. This can cause your brain to swell, leading to brain damage and hypertensive encephalopathy.

Hypoxic ischemic encephalopathy

This condition is a type of brain damage that occurs when the brain does not receive enough oxygen. This can lead to permanent brain damage or dysfunction. It can be caused by a lack of oxygen to the brain, such as when a developing baby is exposed to alcohol in the womb.

Toxic-metabolic encephalopathy

Toxic-metabolic encephalopathy is the result of infections, toxins, or organ failure. When electrolytes, hormones, or other chemicals in the body are out of their normal balance, they can affect brain function .

This can also include the presence of an infection in the body or the presence of toxic chemicals.

Encephalopathy usually resolves when the underlying chemical imbalance is restored or the offending infection / toxin is eliminated.

Infectious encephalopathies

Transmissible spongiform encephalopathies are also known as prion diseases. Prions are proteins that occur naturally in the body, but they can mutate and cause diseases that gradually deteriorate the brain (neurodegenerative diseases). Prion diseases include:

  • Chronic wasting disease.
  • Fatal family insomnia.
  • Creutzfeldt-Jakob disease.

Uremic encephalopathy

Uremic encephalopathy is the result of kidney failure. It is believed to be caused by the accumulation of uremic toxins in the blood. This condition can cause mild confusion to deep coma.

Wernicke encephalopathy

Also known as Wernicke’s disease, this condition is the result of vitamin B-1 deficiency.

Long-term alcoholism, poor nutritional intake, and malabsorption from food can cause a vitamin B-1 deficiency. If Wernicke encephalopathy is not treated quickly, it can lead to Wernicke-Korsakoff syndrome.

What are the symptoms of encephalopathy?

Your symptoms will depend on the cause and severity of your encephalopathy.

Mental changes

  • You may have trouble with memory or focus. You may also have trouble with problem solving skills.
  • Other people may notice symptoms in you before you know it. A changing personality is one of those symptoms. For example, you may be more outgoing than you were before encephalopathy. You may be more or less calm than you were before the illness.
  • You could also be lethargic and sleepy.

Neurological symptoms

Possible neurological symptoms include:

  • Muscle weakness in one area.
  • Poor decision making or concentration.
  • Involuntary contractions
  • Temblor.
  • Difficulty speaking or swallowing.
  • Seizures

When Should You Seek Medical Help?

You should see a doctor right away if you have symptoms of encephalopathy. If you are already receiving treatment for brain disease, watch out for the following signs:

  • Severe confusion
  • Severe disorientation
  • Coma.

These may be signs of a medical emergency. They may mean that your condition is getting worse.

How is encephalopathy diagnosed?

To diagnose encephalopathy, your doctor will ask you questions about your medical history and symptoms. They will also perform a medical exam to check for mental and neurological symptoms.

If your doctor suspects that you have brain disease, they may run tests to determine the causes and severity of your disease. The tests may include:

  • Blood tests to detect diseases, bacteria, viruses, toxins, hormonal or chemical imbalance.
  • Lumbar puncture (your doctor will take a sample of your spinal fluid to look for disease, bacteria, viruses, toxins, or prions).
  • CT or MRI scan of your brain to check for abnormalities or damage.
  • Electroencephalogram (EEG) test to measure electrical activity in your brain.

How is it treated?

Treatment for encephalopathy varies depending on what caused it. Treatment may include medications to treat your symptoms and medications or surgery to treat the underlying cause.

Your doctor may recommend nutritional supplements to decrease the damage to your brain, or a special diet to treat the underlying causes.

In some cases of the disease, such as when the brain does not receive enough oxygen, it can slip into a coma. In severe cases like this, your doctor may put you on life support to keep you alive.

Is encephalopathy preventable?

Some types of encephalopathy, such as inherited types, cannot be prevented. However, other types are preventable.

Making the following changes can reduce your risk of developing many of the underlying causes of encephalopathy:

  • Avoiding excess alcohol.
  • Reduce exposure to toxic substances such as drugs.
  • Eating a healthy diet.
  • See your doctor regularly.
  • Living a healthy lifestyle can help reduce your risk factors for brain disease.

Long-term outlook

Your long-term outlook depends on the cause and severity of your encephalopathy. Many forms of encephalopathy are reversible if the cause can be identified and treated. All types can be fatal if they are severe enough. Some types are always fatal.

According to the National Institute of Neurological Disorders and Stroke, transmissible spongiform encephalopathy usually results in death within three months to a few years from the onset of the disease.

Treatment for the cause of your brain disease can improve your symptoms or eliminate encephalopathy. Depending on the type of encephalopathy, you may or may not have permanent damage to your brain.

Your healthcare team can work with you and your loved ones on ongoing treatment and therapy plans to support your daily life in the event of brain damage.