Many theories have been advanced to explain the encephalopathy associated with chronic
liver disease and with the less common acute form. A major factor contributing to hepatic
encephalopathy is hyperammonemia resulting from portacaval shunting and/or liver
damage. However, an increasing number of causes of hyperammonemic encephalopathy
have been discovered that present with the same clinical and laboratory features found in
acute liver failure, but without liver failure. Here, we critically review the physiology …