What is Encephalopathy (aka “Brain Dysfunction”)?

Which Lab Test Can Confirm a Diagnosis of Encephalopathy?

It is important to identify encephalopathy early. Identification and treatment can, in many cases, eliminate, reduce or stop the symptoms of encephalopathy. 

Various tests can be used to diagnose encephalopathy. Sometimes, we have to presumptively diagnose encephalopathy, if the case is not completely clear or obvious. 

The altered mental state usually presents along with another underlying root cause such as chronic liver disease, kidney failure, anoxia / lack of oxygen or others. Encephalopathy is really a complication, or a side effect, of the primary underlying root cause. The root cause of encephalopathy can be many things. 

Different tests may be used to diagnose the underlying root cause of the encephalopathy.  

Tests often used, which help to identify the possible underlying root cause, are: 

• Cognitive tests to check mental status and memory coordination tests to diagnose an altered mental state.
• A CBC, or Complete Blood Count, blood test which can identify if an infection is present.
• A blood pressure test to check for high or low blood pressure.
• Metabolic tests to check blood levels of electrolytes, glucose, lactate, oxygen, liver enzymes. This helps to identify diabetes or other types of metabolic dysfunction.
• Test for drugs or toxin levels (alcohol, cocaine or other recreational drugs)
• Blood and body fluid cultures to detect diseases, bacteria, viruses, toxins, other pathogens or a hormonal or chemical imbalance.
• A creatine test to look at kidney function.
• Imaging scans (a CT or MRI scan) to check for brain swelling, infections or other abnormalities.
• An ultrasound to see blood flow to tissues or abscesses.
• Encephalogram, or EEG, measures the electrical activity in the brain, to look for brain damage or abnormal brain wave patterns.
• Autoantibody analysis which can check for dementia and antibodies that damage the brain. 
• A review of prescription medications to check if the person is on a medication (for example, cyclosporine) that could be causing the symptoms.

Other tests may be used in diagnosing encephalopathy and its underlying cause. Or it may be that not all of the above tests need to be done on every patient. Specific testing is decided based on the symptoms and medical history of the patient.

How is Encephalopathy Treated?

The treatment protocol for encephalopathy depends entirely on the underlying root cause of the encephalopathy. There is no standard treatment as not all cases of encephalopathy are the same. Encephalopathy is often reversible with treatment. 

Treatment includes symptom management while simultaneously working to resolve the underlying cause.

Treatment can include:

• Symptom management: For example, anticonvulsant medication may be needed to manage seizures and keep the patient safe. 
• Root cause treatment: For example, in Wernicke encephalopathy due to a B1 deficiency, nutritional supplements might be used. Antibiotics are often used to treat encephalopathies caused or triggered by infections. Stopping a medication that causes the symptoms may be required. Changing the diet to address a nutrient deficiency or a condition like diabetes type 2 might be the treatment. In the case of liver or kidney problems, dialysis or even an organ transplant might be the solution. 

If left untreated, encephalopathy can lead to worsening brain function, permanent brain damage or even death.

What is the Outlook for Encephalopathy?

The outlook or prognosis for encephalopathy depends largely on whether the encephalopathy is reversible or irreversible.

Encephalopathy from head injuries, toxins, cardiac arrest, or lack of oxygen to the brain cause physical damage to the brain that is usually permanent. That means the patient’s mental state may not go back to what it was.

In reversible encephalopathy, from organ failure, metabolic conditions, or infections, symptoms usually go away when the underlying problem causing the symptoms is resolved. The patient may be able to regain previous mental abilities. For example, in hepatic encephalopathy, clearing toxins from the blood can resolve the issues with confusion, memory problems or mood swings.

How Can You Prevent Encephalopathy?

Prevention is always better than the cure. It is best to try to avoid getting to the stage f encephalopathy. Cases of encephalopathy can be prevented by avoiding the many primary causes.

You can reduce your risk of encephalopathy by following some basic lifestyle habits include:

• Eat a healthy diet, exercise and maintain a healthy weight.
• Don’t consume excessive amounts of alcohol. If this is a problem, then seek help. 
• Decrease exposure to all types of toxins. Toxins can be in food, water, the air, personal & cosmetic products, household cleaning products, etc.
• Avoid medications that negatively affect the nervous system.
• Reduce the risk of head trauma by avoiding high risk sports and just generally being careful & aware of your surroundings.
• See your Functional Medicine doctor regularly, which can help to catch anything early.

Summary

• Encephalopathy refers to brain dysfunction, brain disease or damage to the brain. Encephalopathy happens when there is a change in how the brain works. It can be any disease that affects the brain and causes changes in mental function. 
• The key symptom is a changed or altered mental state. Memory, focus and problem–solving issues may also be involved. In a severe case, seizures or coma is possible.
• There are over 150 different types of encephalopathy
• Each type has a different cause and a different treatment.
• It is most effective to practice prevention in the case of encephalopathy. Develop healthy lifestyle habits such as a healthy diet, exercise, avoid addictions, decrease exposure to toxins, try to not take medications, avoid high-risk pursuits and activities to avoid head trauma. 
• Check in with a Functional Medicine doctor, or our clinic, to address a case of encephalopathy in yourself or a loved one.

** Follow us for our next Blog on the Functional Medicine approach to Chronic Disease **

As always, please get in touch with us. If you or someone you know is struggling with cognitive or neurological symptoms, contact our clinic today. We can work on any issue(s) and improve your health. Book a free health evaluation call with us today, to see how we can help you with your concerns. We can answer your questions and help you book an initial consult with one of the functional medicine doctors in our clinic.