instruction: hello doctor this is regarding my mother she is years old last year she was diagnosed with chronic liver disease she had ascites which was cured she has taken proper medication since then but recently since the last three weeks to be precised she was having tremors and difficulty in sleeping we consulted gastroenterologist here who gave medicines but did not help much with these symptoms she also has hypothyearoid and type diabetes since the last two days she suddenly developed nausea and vomiting and we had to hospitalize her for now vomiting and nausea have stopped but she is oversleeping and she still has tremors her sodium potassium and creatinine levels are normal and looking at her liver function test the doctor said she has swelling on her liver and nothing more but I read somewhere about the symptoms of hepatic encephalopathy like oversleeping drowsiness flapping tremors etc and she has all those at present am I right regarding this please help me
output: hello I can understand you must be very upset about your mother health the answer to your query is you are 100 right it can be hepatic encephalopathy he it often presents as altered sleep patterns which means day time sleeping and nighttime awakening tremors are characteristically called flapping tremors and sometimes overt neuropsychiatric manifestations such as elevated mood hallucinations and illusions the treatment of he is simple I to avoid constipation and use of lactulose a special laxative agent that help to decrease ammonia gas that causes he plus she should be given tablet rifxamin 50 my twice daily to prevent her from recurrent episodes of he the recent use of painkillers could have caused kidney damage which got recovered and may be a precipitating factor for the underlying development of hepatic encephalopathy I hope this will help you in understanding her problem I want that you should discuss this information with her treating physician can follow up to discuss more about the long term management of chronic liver disease