Hepatic encephalopathy presenting with acute neurologic deficits in cirrhosis: case report and practical diagnostic approach

Abstract

Overt hepatic encephalopathy (OHE) occurs in approximately 30–45% of patients with cirrhosis and remains a frequent cause of acute altered mental status requiring urgent evaluation [1, 2]. In the emergency setting, OHE can present as a stroke mimic (metabolic encephalopathy) and diagnostic delays are common; therefore, early recognition and prompt identification of precipitating factors are critical to initiate targeted therapy and avoid unnecessary stroke-directed interventions