What You Need to Know About Encephalopathy
Alcohol-related encephalopathy is a common condition in people who abuse alcohol. It isn’t widely talked about because it is something that people suffer from because of an underlying medical condition, such as liver disease. Understanding what encephalopathy is, and the risks it has can help you see that treatment for alcohol addiction is incredibly important.
Encephalopathy is a brain disease. When the brain is damaged or malfunctions, medical professionals refer to it as “encephalopathy.”
People suffering from encephalopathy experience:
- Memory loss
- Personality changes
- Altered mental state
- Poor coordination
- Muscle twitching
- Cheyne-Stokes respirations
Many types of encephalopathy have been identified, such as anoxic encephalopathy, which is when a person suffers brain damage because of a lack of oxygen. Hepatic encephalopathy is when the brain malfunction because the person suffers from liver disease. Wernicke’s encephalopathy is also associated with alcohol use due to nutritional deficits.
This type of encephalopathy produces delirium, and it’s a neurological disorder that is often caused by deficiencies in thiamine and vitamin B1.
Wernicke’s encephalopathy was identified by a German neurologist by the name of Dr. Carl Wernicke in 1881 after he noticed mental confusion, ataxia, and ophthalmoplegia in one of his patients. Through his observations, he concluded that this condition as one that is mostly exhibited by memory loss and confabulation.
Deficiency in thiamine is often seen in those who suffer from chronic alcoholism. Alcohol blocks thiamine uptake and utilization causing the deficiency. Long-term alcoholics have a reduction in intestinal thiamine absorption of about 70%, which means that sufferers have 30% to 98% less thiamine than healthy individuals.
Not all alcoholics will suffer from thiamine deficiency. Those who are genetically disposed to having low thiamine levels or don’t eat enough foods with thiamine in them are at an increased risk of suffering from the condition.
Other Causes of Encephalopathy
Encephalopathy isn’t caused by one condition or event. It has many causes, which can make it difficult for medical professionals to identify the root of the condition.
A few of the causes of encephalopathy are:
- Liver disease
- Kidney disease or failure
- Metabolic disease
- Brain tumor
- Traumatic brain injuries causing a lack of oxygen
- Toxicity from mercury, lead or ammonia
- Brain pressure, as seen with tumors or abscesses
- Inadequate nutrition
In the case of people who are addicted to alcohol, medical professionals usually identify that as the cause of the condition. Since many people are not as forthcoming with an accurate account of their drinking, doctors can often conclude it’s an alcohol-related cause because of the following symptoms:
- Liver damage
- Hand tremors
- Lack of oxygen
- Cranial nerve palsies
How Alcohol Induced Encephalopathy Is Diagnosed
Clinical tests are performed during a physical exam. Patients receive many mental assessments during the testing due to the altered mental state common with encephalopathy.
Other tests are performed for liver disease, kidney failure, anoxia, and other medical conditions. Since liver disease is caused by alcohol abuse, it is also an indication of encephalopathy.
In an attempt to rule out any other medical problems, doctors often test for the following:
- Blood pressure
- Electrolyte levels
- Liver enzymes
- Kidney functioning
- Brain swelling
- Anatomical abnormalities
- Abnormal blood flow
- Abnormal brain wave patterns
- Medication side effects
Not all of these tests are performed on all patients. Doctors often choose which ones they feel are most needed for an accurate diagnosis.
Encephalopathy treatment varies and is determined by the symptoms and causes.
For alcohol-related encephalopathy, treatment includes either IV fluids or oral lactulose, antibiotics and a low protein diet.
If the condition is left untreated and worsens to the point of static encephalopathy, the person may need rehabilitation to perform at his highest level of functioning.
The Risk of Death with Encephalopathy
Encephalopathy can be mild or severe, which is life threatening. What is important to understand is that encephalopathy doesn’t necessarily cause death. Instead, it’s the underlying medical problem that causes a sufferer to die.
For example, if someone suffers from alcoholism, and this leads to liver damage. The person may suffer from severe encephalopathy because of the liver damage, and die because of it.
The prognosis of encephalopathy depends on the severity of the condition. Mild cases are often resolved with treatment. As long as the cause of the condition is treated, encephalopathy should not return.
Wernicke’s encephalopathy can be treated with high doses of thiamine. Although, the neurologic dysfunction can continue after the treatment process has concluded. Those who have significant neurological impairment even after thiamine repletion, may end up with a permanent neurological disability. Long-term institutionalization may be required, and only 20% of those who enter long-term treatment recover.
Permanent brain damage has occurred in severe cases. This often happens because a person did not receive treatment for the underlying medical problem, which caused extensive damage to the brain. The brain is resilient, unless it is compounded by extreme stress from other areas of the body.
Preventing Alcohol-Related Encephalopathy
The best way to prevent alcohol-related encephalopathy is to refrain from abusing alcohol. Alcohol toxicity causes many long-term issues, so it’s important to decrease and stop drinking as soon as possible.
Due to the sudden onset of encephalopathy after the liver has been damaged, many people suffering from alcoholism will only enter alcohol addiction treatment after they have been diagnosed. By this time, the liver damage may be too much, and prognosis is bleak.
If you’re suffering from alcohol addiction, it’s crucial you seek help now BEFORE encephalopathy sets in along with other alcohol-related medical conditions.
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