Skip to content 
Personality changes
Hepatic encephalopathy is caused by ammonia buildup in the brain. This substance is usually metabolized in the liver and eliminated right away. But now, the liver is not doing this job properly, and similar to bilirubin, ammonia accumulates in the blood and is distributed in many tissues, especially the central nervous system. As it builds up, ammonia starts interacting with neurotransmitters, causing changes in how the person reacts to certain stimuli, especially stress and the sensation of danger. The patient may turn into a depressive mood or become particularly resentful and temperamental, with constant mood swings.
