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在严重肝病时,可能出现神经精神改变并进入昏迷。这称为肝性脑病。早期表现是行为失常,后期在进入昏迷之前可能有欣快或倦睡,精神错乱,运动失调和特有的扑翼样震颤。病程常有波动,可在任何阶段停止或好转。扑翼样震颤是肝性脑病的特征,但不是该病所特有的。在严重的心力衰竭、呼吸衰竭或肾功能衰竭时,它亦可出现。在肝性脑病时,脑电图有特征性的异常,包括发作性的双侧同步对称的每秒1 1/2～3δ范围的高伏特慢波,夹杂在或加在相对正常的α波上。这些改变亦不仅见于肝性脑病,其它严重代谢性疾病时也可出现。
In severe liver disease, neuropsychiatric changes may occur and into a coma. This is called hepatic encephalopathy. Early manifestations are behavioral disorders, which later may have euphoria or drowsiness before sleeping, confusion, ataxia and a unique flapping-wing tremor. The course of the disease often fluctuates and can be stopped or improved at any stage. Asterixis is characteristic of hepatic encephalopathy, but not specific to the disease. It can also occur in severe heart failure, respiratory failure, or renal failure. In hepatic encephalopathy, there are characteristic abnormalities of the EEG, including the onset of bilateral sychronistic symmetry of high-voltage slow waves in the range of 1 1/2 to 3 δ per second, implanted in or added to the relatively normal α-wave . These changes are not only seen in hepatic encephalopathy, but also in other serious metabolic diseases.