Hepatic Coma
1961; Elsevier BV; Volume: 41; Issue: 1 Linguagem: Inglês
10.1016/s0016-5085(19)35172-8
ISSN1528-0012
Autores Tópico(s)Liver Disease and Transplantation
ResumoHepatic precoma and coma may be defined briefly as a syndrome characterized by disordered consciousness, confusion, the general features of organic psychosis, a flapping tremor of the outstretched hands, hypertonicity with flexor plantar responses until terminally, and fetor hepaticus.It can complicate liver disease of many different causes but is most frequently associated with Laennec's cirrhosis; acute viral hepatitis is the next most important cause.The neuropsychiatric picture is not specifically associated with liver disease but can be found in uremia 1 and in pulmonary and circulatory failure. 2 • 3 In these conditions, however, the distinctive fetor hepaticus is not found.The clinical course is very fluctuant, and frequent observation of the patient is necessary.A rough clinical grading 4 should be used, for example:Grade 0. Normal.Grade 1. Trivial apathy or euphoria with or without objective neurologic signs.Grade 2. Personality change with neurologic abnormality.Grade 3 .
Referência(s)