Liquid diagnosis of hepatic encephalopathy : are we there already?

© 2020 Sociedade Portuguesa de Gastrenterologia Published by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any dis-tribution of modified material requires written permission.Hepatic encephalopathy (HE) is a neurocognitive syndrome associated with liver disease and/or portosystemic shunts. Its diagnosis is clinical and requires exclusion of many other conditions that can present with similar neuropsychiatric abnormalities. The broad differential diagnosis, and huge clinical overlap with many metabolic, neurologic and psychiatric disorders, is a challenge for clinicians that must decide in which patients further laboratorial, imaging and neurophysiological investigation is warranted.