Anticonvulsants in Hepatic Encephalopathy
Abstract
Hepatic encephalopathy (HE) is a complex neurological syndrome that arises as a complication of liver dysfunction. The primary focus in HE management has traditionally been on ammonia detoxification, but recent research has paved light on the potential role of anticonvulsant medications in improving the cognitive impairment and preventing seizures associated with HE. This review mainly aims to provide a comprehensive analysis of the use of anticonvulsants in hepatic encephalopathy, by taking a looking at their mechanisms of action, efficacy, and safety profiles.
Keywords: Hepatic encephalopathy, Anticonvulsants, Cognitive impairment
Keywords:
Hepatic encephalopathy, Anticonvulsants, Cognitive impairmentDOI
https://doi.org/10.22270/jddt.v14i4.6506References
Wijdicks E.F. Hepatic encephalopathy. N Engl J Med. 2016; 375:1660-1670. https://doi.org/10.1056/NEJMra1600561 PMid:27783916
Vilstrup H, Amodio P, Bajaj J, Cordoba J, Ferenci P, Mullen KD, Weissenborn K, Wong P. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the study of liver diseases and the European Association for the study of the liver. Hepatology. 2014;60:715-35. https://doi.org/10.1002/hep.27210 PMid:25042402
Prakash R., Mullen K.D. Mechanisms, diagnosis and management of hepatic encephalopathy. Nat Rev Gastroenterol Hepatol. 2010; 7: 515. https://doi.org/10.1038/nrgastro.2010.116 PMid:20703237
Patsalos PN. Pharmacokinetic profile of levetiracetam: toward ideal characteristics. Pharmacol Ther. 2000; 85:77-85. https://doi.org/10.1016/S0163-7258(99)00052-2 PMid:10722121
Bajaj JS, Wade JB, Sanyal AJ. Spectrum of neurocognitive impairment in cirrhosis: implications for the assessment of hepatic encephalopathy. Hepatology 2009; 50:2014-2021. https://doi.org/10.1002/hep.23216 PMid:19787808
Zheng F, Du C, Wang X. Levetiracetam for the treatment of status epilepticus. Exp Rev Neurother. 2015; 15:1113-1121. https://doi.org/10.1586/14737175.2015.1088785 PMid:26416394
Tapper EB, Parikh ND, Sengupta N, Mellinger J, Ratz D, Lok AS, et al. A risk score to predict the development of hepatic encephalopathy in a population-based cohort of patients with cirrhosis. Hepatology 2018; 68:1498-1507. https://doi.org/10.1002/hep.29628 PMid:29091289
Prabhakar S, Bhatia R. Management of agitation and convulsions in hepatic encephalopathy. Indian J Gastroenterol. 2003 Dec;22 Suppl 2:S54-8. PMID: 150252577. Eleftheriadis N, Fourla E, Eleftheriadis D, Karlovasitou A. Status epilepticus as a manifestation of hepatic encephalopathy. Acta Neurol Scand. 2003; 107:142-4. https://doi.org/10.1034/j.1600-0404.2003.02092.x PMid:12580865
Vidaurre J, Gedela S, Yarosz S. Antiepileptic drugs and liver disease. Pediatr Neurol. 2017; 77:23-36. https://doi.org/10.1016/j.pediatrneurol.2017.09.013 PMid:29097018
Cui B, Wei L, Sun LY, Qu W, Zeng ZG, Liu Y, Zhu ZJ. Status epilepticus as an initial manifestation of hepatic encephalopathy: A case report. World J Clin Cases 2020; 8(24):6480-6486. https://doi.org/10.12998/wjcc.v8.i24.6480 PMid:33392334 PMCid:PMC7760455
Hirode, G., Vittinghoff, E. & Wong, R.J. Increasing Burden of Hepatic Encephalopathy Among Hospitalized Adults: An Analysis of the 2010-2014 National Inpatient Sample. Dig Dis Sci 2019;64:1448-1457. https://doi.org/10.1007/s10620-019-05576-9 PMid:30863953
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