?Acute fatty liver of pregnancy period ? 70% caused by cirrhosisРPrecipitating factors of HEР1) Gastrointestinal BleedingР2) Abuse of sedatives and narcoticР3) Massive paracentesis and excessive diuresisР4) InfectionsРHypovolemia, shock, hypoxiaРProtein breakdownРAmmonia productionРbenzodiazepines and barbituratesРFluid or electrolyte abnormalities and acid base disturbanceРtissue breakdownРSeveral main hypothesesРAmmonia Intoxication?False Neurotransmitters?Amino Acid imbalance?The Gamma-Amino butyric ? Acid hypothesisРSymptomsР(prodromal stage) Slightly altered mood or behaviors?(a stage) Somnipathy and inappropriate behaviors?(lethargic stage) Drowsy and psychopath?(coma stage )aРcentral nervous systemРFour stages of hepatic encephalopathyРFlapping tremorРPatient РB. Doctor and patient
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