Management of Hepatic Encephalopathy as an Inpatient

This review is limited to the management of inpatients with clinically overt hepatic encephalopathy (HE) due to cirrhosis.1 Type C overt HE should be divided into episodic HE (when the symptoms develop over a short period and fluctuate in severity), recurrent HE (characterized by bouts of HE within a time interval of 6 months or less), or persistent HE (with continuous behavioral or neurological symptoms). Another important distinction is between spontaneous and precipitated HE, the latter induced by a specific and clearly identifiable precipitating event. The above taxonomy of overt HE (episodic versus recurrent versus persistent, precipitated versus spontaneously occurring) is clinically relevant because the diagnostic procedures and management of each category differ.