Table of ContentsView AllTable of ContentsTypes and CausesSymptomsDiagnosisTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Types and Causes
Symptoms
Diagnosis
Treatment
Prevention
Encephalopathy refers to any abnormality in the brain’s function or structure. Causes of encephalopathy include infections, traumatic brain injury, and exposure to toxins. Without treatment, temporary or permanent brain damage, loss of consciousness, and even death can occur.
The signs and symptoms of encephalopathy vary depending on type, cause, and severity. However, some of the most common features include memory loss, personality changes, delirium, tremors, and more.
This article covers the types, causes, and symptoms of encephalopathy along with how it is diagnosed and treated. It also provides important advice for how to avoid encephalopathy.
SDI Productions / E+ / Getty Images
Types of Encephalopathy and Causes
Encephalopathy can be acute or chronic. Types of acute encephalopathy include:
Chronic encephalopathies include:
Chronic Traumatic Encephalopathy
Chronic traumatic encephalopathy(CTE) is a progressive (gradually increasing), degenerative (worsening) brain condition linked to repeated blows to the head over a long time period.
While the prevalence of CTE isn’t truly known, this type of encephalopathy tends to affect athletes in contact sports (like American football), military personnel who have been exposed to repetitive blunt head trauma, and victims of domestic abuse.
Symptoms of CTE don’t develop right away after head trauma—it will take years of repeated head trauma. Long term effects include depression, memory problems, impulsive behavior, and difficulty making decisions and carrying out tasks.
Hashimoto’s Encephalopathy
Features of HE includeseizures, confusion, anddementia. It is also known to causepsychosis, includingvisual hallucinationsand paranoid delusions.
Hypoxic-Ischemic Encephalopathy
Hypoxic-ischemic encephalopathy (HIE)—also known asglobal hypoxic-ischemic injury—is a type of diffuse brain dysfunction that happens when the brain doesn’t get enough oxygen for a period of time.
In adults, hypoxic-ischemic injury is usually related to acardiac arrest, while in older children, the most common causes are drowning and choking.
In newborns, HIE can occur prior to birth, during delivery, or shortly after birth. Causes can include pregnancy issues, trauma during delivery, and umbilical knots.
The range in outcome after HIE varies tremendously. Some babies with HIE will not have noticeable effects, some may suffer permanent brain damage, and others might not survive.
Hypertensive Encephalopathy
Hypertensive encephalopathy is generalized brain dysfunction due to sudden, markedlyhigh blood pressure. Symptoms of hypertensive encephalopathy include headaches, vomiting, balance problems, and confusion. It can lead to seizures or bleeding in the back of the eye.
Hypertensive encephalopathy can occur due to severe kidney failure or from abruptly stopping blood pressure medications.
Infectious Encephalopathies
Infectious encephalopathies are the most serious types of encephalopathies. They result from transmissible spongiform encephalopathies, also known asprion diseases, including:
Metabolic Encephalopathy
Metabolic encephalopathy occurs when a health condition—like diabetes, kidney failure, heart failure, or liver disease—affects proteins, electrolytes, or nutrients in a way that makes it hard for the brain to work. For example, high blood sugar can lead to confusion or a coma.
Neurological symptoms are common if the underlying cause isn’t optimally treated. Sometimes, brain problems associated with metabolic encephalopathies are reversible.
Wernicke Encephalopathy
Uremic Encephalopathy
Uremic encephalopathy occurs due to kidney failure, which can cause a buildup of uremic toxins in the brain.
Symptoms include lethargy, confusion, seizures, or coma. Uremic encephalopathy is treated with dialysis or a kidney transplant.
Glycine Encephalopathy
Glycine encephalopathy is a genetic or inherited condition in which there are abnormally high levels ofglycine(an amino acid) in the brain.
Symptoms of this type of encephalopathy appear in newborn infants and include:
Hepatic Encephalopathy
Hepatic encephalopathycan occur with cirrhosis—chronic liver damage that leads to liver scarring andliver failure.
With hepatic encephalopathy, the liver cannot adequately remove toxins from the blood, and these toxins eventually lead to brain damage.
This type of encephalopathy can be acute (short-term) or chronic (long-term). In some instances, a person with hepatic encephalopathy can become unresponsive and may experience a coma.
Features of Encephalopathy
The symptoms of encephalopathy are associated with its cause.
Some of the most common symptoms across all types of encephalopathy include:
Encephalopathy may cause:
If you or a loved one develop any of these symptoms, you should get prompt medical attention.
If you or your loved one have already been diagnosed with encephalopathy, be aware of the following complications:
These are signs of a medical emergency that require immediate care.
Diagnosing Encephalopathy
If you are being evaluated for possible encephalopathy, your healthcare provider will ask about your medical history and all medications you are taking. They will also give you a physical examination andneurological examinationand may request additional tests.
Tests that may be part of encephalopathy diagnosis include:
The test results can help your healthcare provider determine if you have encephalopathy, the type of encephalopathy, and what caused it.
Treatment for Encephalopathy
Untreated encephalopathy can lead to worsening or permanent brain damage or death. Treatment includes symptom management and relieving the underlying cause. For example, with Hashimoto’s encephalopathy, standard therapy includesglucocorticoidsandimmunosuppressive medications.
Nutritional supplementation may be recommended to slow down brain damage or to help manage an underlying metabolic condition.
Treatment for chronic traumatic encephalopathy may include behavior therapy, pain management, and cognitive training to improve thinking and problem-solving skills.
Recurrent seizures would be prevented withanticonvulsant drugs.
In rare cases, severe encephalopathy can cause loss of consciousness or coma. If this happens, you will need respiratory support as you are recovering.
Preventing Encephalopathy
Some types of encephalopathy can be prevented, while others are not preventable. For example, genetic types of encephalopathy, like glycine encephalopathy, aren’t preventable—but hepatic encephalopathy might be.
Certain lifestyle changes may reduce your risk of developing encephalopathy.
Beneficial lifestyle adjustments can include:
Summary
Encephalopathy can occur as a result of any disease or injury that alters the brain’s functions or structure. Features of encephalopathy include decreased mental ability, confusion, decreased muscle coordination, and vision or eye changes. If you experience any of these symptoms, get immediate medical help. The sooner you get medical attention, the sooner you can recover from impaired brain function.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Premier Health.Physicians advisor’s corner: Clearing the confusion about encephalopathy.Baugh CM, Robbins CA, Stern RA, et al.Current understanding of chronic traumatic encephalopathy.Curr Treat Options Neurol. 2014;16(9):306. doi:10.1007/s11940-014-0306-5Liyanage CK, Munasinghe TMJ, Paramanantham A.Steroid-responsive encephalopathy associated with autoimmune thyroiditis presenting with fever and confusion.Case Rep Neurol Med. 2017;2017:3790741. doi:10.1155/2017/3790741Heinz UE, Rollnik JD.Outcome and prognosis of hypoxic brain damage patients undergoing neurological early rehabilitation.BMC Res Notes. 2015;8:243. doi:10.1186/s13104-015-1175-zKorf J, McCullough L, Caretti V.A narrative review on treatment strategies for neonatal hypoxic ischemic encephalopathy.Transl Pediatr. 2023 Aug;12(8):1552–1571. doi:10.21037/tp-23-253Halimi JM, de Fréminville JB, Gatault P, et al.Characteristic and prognosis of patients with hypertensive encephalopathy: A French nationwide cohort study.Hypertension. 2023 Jun;80(1):1716–1727. doi:10.1161/HYPERTENSIONAHA.123.21226Centers for Disease Control and Prevention.Prion diseases.Jeon S, Choi S, Kim H, Yu I.Acute acquired metabolic encephalopathy based on diffusion MRI.Korean J Radiol. 2021 Dec;22(12):2034-2051. doi:10.3348/kjr.2019.0303Sinha S, Kataria A, Kolla BP, et. al.Wernicke encephalopathy-Clinical Pearls.Mayo Clin Proc. 2019;94(6):1065-1072. doi:10.1016/j.mayocp.2019.02.018Rosner M, Husain-Syed F, Reis T, Ronco C, Vanholder R.Uremic encephalopathy.Kidney Int. 2022 Feb;101(2):227-241. doi:10.1016/j.kint.2021.09.025Genetic and Rare Diseases Information Center.Glycine encephalopathy.Genetic and Rare Diseases Information Center.Hepatic encephalopathy.Chaudhuri J, Mukherjee A, Chakravarty A.Hashimoto’s encephalopathy: Case series and literature review.Curr Neurol Neurosci Rep. 2023;23(4):167–175. doi:10.1007/s11910-023-01255-5Pierre K, Dyson K, Dagra A, Williams E, Porche K, Lucke-Wold B.Chronic traumatic encephalopathy: Update on clinical diagnosis and management.Biomedicines. 2021 Apr;9(4):415. doi:10.3390/biomedicines9040415
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Premier Health.Physicians advisor’s corner: Clearing the confusion about encephalopathy.Baugh CM, Robbins CA, Stern RA, et al.Current understanding of chronic traumatic encephalopathy.Curr Treat Options Neurol. 2014;16(9):306. doi:10.1007/s11940-014-0306-5Liyanage CK, Munasinghe TMJ, Paramanantham A.Steroid-responsive encephalopathy associated with autoimmune thyroiditis presenting with fever and confusion.Case Rep Neurol Med. 2017;2017:3790741. doi:10.1155/2017/3790741Heinz UE, Rollnik JD.Outcome and prognosis of hypoxic brain damage patients undergoing neurological early rehabilitation.BMC Res Notes. 2015;8:243. doi:10.1186/s13104-015-1175-zKorf J, McCullough L, Caretti V.A narrative review on treatment strategies for neonatal hypoxic ischemic encephalopathy.Transl Pediatr. 2023 Aug;12(8):1552–1571. doi:10.21037/tp-23-253Halimi JM, de Fréminville JB, Gatault P, et al.Characteristic and prognosis of patients with hypertensive encephalopathy: A French nationwide cohort study.Hypertension. 2023 Jun;80(1):1716–1727. doi:10.1161/HYPERTENSIONAHA.123.21226Centers for Disease Control and Prevention.Prion diseases.Jeon S, Choi S, Kim H, Yu I.Acute acquired metabolic encephalopathy based on diffusion MRI.Korean J Radiol. 2021 Dec;22(12):2034-2051. doi:10.3348/kjr.2019.0303Sinha S, Kataria A, Kolla BP, et. al.Wernicke encephalopathy-Clinical Pearls.Mayo Clin Proc. 2019;94(6):1065-1072. doi:10.1016/j.mayocp.2019.02.018Rosner M, Husain-Syed F, Reis T, Ronco C, Vanholder R.Uremic encephalopathy.Kidney Int. 2022 Feb;101(2):227-241. doi:10.1016/j.kint.2021.09.025Genetic and Rare Diseases Information Center.Glycine encephalopathy.Genetic and Rare Diseases Information Center.Hepatic encephalopathy.Chaudhuri J, Mukherjee A, Chakravarty A.Hashimoto’s encephalopathy: Case series and literature review.Curr Neurol Neurosci Rep. 2023;23(4):167–175. doi:10.1007/s11910-023-01255-5Pierre K, Dyson K, Dagra A, Williams E, Porche K, Lucke-Wold B.Chronic traumatic encephalopathy: Update on clinical diagnosis and management.Biomedicines. 2021 Apr;9(4):415. doi:10.3390/biomedicines9040415
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Premier Health.Physicians advisor’s corner: Clearing the confusion about encephalopathy.Baugh CM, Robbins CA, Stern RA, et al.Current understanding of chronic traumatic encephalopathy.Curr Treat Options Neurol. 2014;16(9):306. doi:10.1007/s11940-014-0306-5Liyanage CK, Munasinghe TMJ, Paramanantham A.Steroid-responsive encephalopathy associated with autoimmune thyroiditis presenting with fever and confusion.Case Rep Neurol Med. 2017;2017:3790741. doi:10.1155/2017/3790741Heinz UE, Rollnik JD.Outcome and prognosis of hypoxic brain damage patients undergoing neurological early rehabilitation.BMC Res Notes. 2015;8:243. doi:10.1186/s13104-015-1175-zKorf J, McCullough L, Caretti V.A narrative review on treatment strategies for neonatal hypoxic ischemic encephalopathy.Transl Pediatr. 2023 Aug;12(8):1552–1571. doi:10.21037/tp-23-253Halimi JM, de Fréminville JB, Gatault P, et al.Characteristic and prognosis of patients with hypertensive encephalopathy: A French nationwide cohort study.Hypertension. 2023 Jun;80(1):1716–1727. doi:10.1161/HYPERTENSIONAHA.123.21226Centers for Disease Control and Prevention.Prion diseases.Jeon S, Choi S, Kim H, Yu I.Acute acquired metabolic encephalopathy based on diffusion MRI.Korean J Radiol. 2021 Dec;22(12):2034-2051. doi:10.3348/kjr.2019.0303Sinha S, Kataria A, Kolla BP, et. al.Wernicke encephalopathy-Clinical Pearls.Mayo Clin Proc. 2019;94(6):1065-1072. doi:10.1016/j.mayocp.2019.02.018Rosner M, Husain-Syed F, Reis T, Ronco C, Vanholder R.Uremic encephalopathy.Kidney Int. 2022 Feb;101(2):227-241. doi:10.1016/j.kint.2021.09.025Genetic and Rare Diseases Information Center.Glycine encephalopathy.Genetic and Rare Diseases Information Center.Hepatic encephalopathy.Chaudhuri J, Mukherjee A, Chakravarty A.Hashimoto’s encephalopathy: Case series and literature review.Curr Neurol Neurosci Rep. 2023;23(4):167–175. doi:10.1007/s11910-023-01255-5Pierre K, Dyson K, Dagra A, Williams E, Porche K, Lucke-Wold B.Chronic traumatic encephalopathy: Update on clinical diagnosis and management.Biomedicines. 2021 Apr;9(4):415. doi:10.3390/biomedicines9040415
Premier Health.Physicians advisor’s corner: Clearing the confusion about encephalopathy.
Baugh CM, Robbins CA, Stern RA, et al.Current understanding of chronic traumatic encephalopathy.Curr Treat Options Neurol. 2014;16(9):306. doi:10.1007/s11940-014-0306-5
Liyanage CK, Munasinghe TMJ, Paramanantham A.Steroid-responsive encephalopathy associated with autoimmune thyroiditis presenting with fever and confusion.Case Rep Neurol Med. 2017;2017:3790741. doi:10.1155/2017/3790741
Heinz UE, Rollnik JD.Outcome and prognosis of hypoxic brain damage patients undergoing neurological early rehabilitation.BMC Res Notes. 2015;8:243. doi:10.1186/s13104-015-1175-z
Korf J, McCullough L, Caretti V.A narrative review on treatment strategies for neonatal hypoxic ischemic encephalopathy.Transl Pediatr. 2023 Aug;12(8):1552–1571. doi:10.21037/tp-23-253
Halimi JM, de Fréminville JB, Gatault P, et al.Characteristic and prognosis of patients with hypertensive encephalopathy: A French nationwide cohort study.Hypertension. 2023 Jun;80(1):1716–1727. doi:10.1161/HYPERTENSIONAHA.123.21226
Centers for Disease Control and Prevention.Prion diseases.
Jeon S, Choi S, Kim H, Yu I.Acute acquired metabolic encephalopathy based on diffusion MRI.Korean J Radiol. 2021 Dec;22(12):2034-2051. doi:10.3348/kjr.2019.0303
Sinha S, Kataria A, Kolla BP, et. al.Wernicke encephalopathy-Clinical Pearls.Mayo Clin Proc. 2019;94(6):1065-1072. doi:10.1016/j.mayocp.2019.02.018
Rosner M, Husain-Syed F, Reis T, Ronco C, Vanholder R.Uremic encephalopathy.Kidney Int. 2022 Feb;101(2):227-241. doi:10.1016/j.kint.2021.09.025
Genetic and Rare Diseases Information Center.Glycine encephalopathy.
Genetic and Rare Diseases Information Center.Hepatic encephalopathy.
Chaudhuri J, Mukherjee A, Chakravarty A.Hashimoto’s encephalopathy: Case series and literature review.Curr Neurol Neurosci Rep. 2023;23(4):167–175. doi:10.1007/s11910-023-01255-5
Pierre K, Dyson K, Dagra A, Williams E, Porche K, Lucke-Wold B.Chronic traumatic encephalopathy: Update on clinical diagnosis and management.Biomedicines. 2021 Apr;9(4):415. doi:10.3390/biomedicines9040415
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
