Survival time of hepatic encephalopathy

The survival time of hepatic encephalopathy can be said to be long or short. For patients with good physical condition and smooth treatment and recuperation, some can survive for more than ten years. The key is to actively receive treatment after the onset of the disease, especially to control the primary disease and avoid the aggravation of hepatic encephalopathy. Daily care and the patient's physical condition are both important factors in determining survival time.

What are the late symptoms of hepatic encephalopathy?

Phase I (prodromal phase)

Mild personality changes and behavioral abnormalities, such as euphoria or apathy, untidy clothing, or urinating or defecating in public. The responses are accurate, but the speech is unclear and slow. There may be flapping tremor (asteris), also known as hepatic tremor. The patient is asked to stretch out both arms, fix the elbows, extend the palms toward the back, and spread the fingers. The hands can be seen deviating to the outside, and the metacarpophalangeal joints, wrist joints, and even elbow and shoulder joints may shake irregularly. Ask the patient to hold the doctor's hand tightly for one minute. The doctor can feel the patient's trembling. EEG is usually normal. This period lasts for several days or weeks, and sometimes the symptoms are not obvious and can be easily ignored.

Stage 2 (pre-coma)

The main symptoms are confusion, sleep disorders and abnormal behavior. Symptoms from the previous period worsen. Orientation and comprehension are poor, the concepts of time, place, and people are confused, and simple calculations and intellectual composition (such as stacking, making a five-pointed star with matchsticks) cannot be completed. Slurred speech, writing disorders, and abnormal behavior are also common. They often have irregular sleep schedules, sleeping during the day and waking at night, and even hallucinations, fear, and mania, and are considered to be common mental illnesses. Patients at this stage have obvious neurological signs, such as hyperreflexia of tendon, increased muscle tension, ankle clonus and positive Babinski sign. During this period, flapping tremors are present and the electroencephalogram has characteristic abnormalities. Patients may experience involuntary movements and movement disorders.

Stage 3 (sleeping stage)

The main symptoms are drowsiness and mental confusion, with various neurological signs persisting or worsening. The patient is in a drowsy state most of the time but can be awakened. When awake, they can still answer questions, but they often feel confused and have hallucinations. Asterixis can still be elicited. Muscle tone increases, and passive movement of the limbs is often resistant. Pyramidal tract signs are often positive and the EEG has abnormal waveforms.

Stage IV (coma)

Complete loss of consciousness and cannot be awakened. In a light coma, there is still response to painful stimulation and uncomfortable position, and tendon reflexes and muscle tone are still hyperactive; because the patient cannot cooperate, flapping tremors cannot be induced. In a deep coma, all reflexes disappear. Muscle tone is reduced, pupils are often dilated, and paroxysmal convulsions, ankle clonus, and hyperventilation may occur. The EEG was obviously abnormal.

Warm reminder: hepatic encephalopathy is a serious complication that is common in the late stages of cirrhosis and liver cancer. If improper care and treatment are not provided, the mortality rate is extremely high. Therefore, patients with cirrhosis and liver cancer, especially those in the middle and late stages of cirrhosis and liver cancer, should actively take preventive measures to greatly reduce the incidence of hepatic encephalopathy.