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DR Medhat MRCP

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• Investigations :<br />

LFT .<br />

EEG.<br />

Amonia level.<br />

Brain CT/MRI, ABG : to R/O other causes.<br />

• Management :<br />

1) Dietary protein restriction ( recently discovered that it`s of no value).<br />

2) Lactulose enema/4 hrs ( wash the colon bacteria & noxious agents).<br />

3) Oral lactulose when the patient starts to be awake.<br />

4) Neomycin & flagyl<br />

5) Branched chain aa (competitive – of aromatic aa , no evidence of its value).<br />

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