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 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. Adjectives are one of the English parts of speech, although they were historically classed together with the nouns. Certain words that were traditionally considered to be adjectives, including "the", "this", "my", etc., are today usually classed separately, as determiners. "Adjective" comes from Latin "" "additional (noun)", a calque of . In the grammatical tradition of Latin and Greek, because adjectives were inflected for gender, number, and case like