Hepatic encephalopathy An imbalance between aromatic amino acids (phenylalanine, tryptophan and tyrosine) and branched-chain amino acids (leucine, isoleucine and valine) has been described; this would lead to the generation of false neurotransmitters (such octopamine and 2-hydroxyphenethylamine). Dysregulation of the serotonin system, too, has been reported. Depletion of zinc and accumulation of manganese may play a role. Inflammation elsewhere in the body may precipitate encephalopathy through the action of cytokines and bacterial lipopolysaccharide on astrocytes. The diagnosis of hepatic encephalopathy can only be made in the presence of confirmed liver disease (types A and C) or a portosystemic shunt (type B), as its
Adjective the end of the word, as in Latin: In Celtic languages, however, initial consonant lenition marks the adjective with a feminine singular noun, as in Irish: Often, distinction is made here between attributive and predicative usage. In English, adjectives never agree, and in French, they always agree. In German, they agree only when they are used attributively, and in Hungarian, they agree only when they are used predicatively: Adjective In linguistics, an adjective (abbreviated ) is a describing word, the main syntactic role of which is to qualify a noun or noun phrase, giving more information about the object signified.