progresses rapidly, presence of waxing and waning cerebral dysfunction in the setting of liver failure.
impaired attention and concentration, altered sleep patterns, abnormal visuospatial perception, and subtle personality changes. Increased muscle tone, hyperreflexia, and extensor plantar responses
due to accumulation of neurotoxic substances leading to increased brain glutamine concentrations, depressed glutamatergic neurotransmission, and increased expression of the peripheral-type benzodiazipine receptors
path: alzheimer type II astrocyte that are metabolically hyperactive