Metabolic encephalopathy (ME) occurs when problems with your metabolism cause brain dysfunction. Causes range from low blood sugar to excess fluid in your brain. Symptoms may include confusion or coma.

If you or someone you care for is diagnosed with an encephalopathy, it means they’re experiencing a brain dysfunction. There are many types of encephalopathies, and their effects can be temporary or permanent.

Metabolic encephalopathies (ME) are brain dysfunctions due to problems with your metabolism, or your body’s chemical processes that turn food into energy and filter out harmful toxins.

There are several causes of ME, but they generally can be broken into two groups: those that deprive your brain of something it needs, and those that allow a buildup of something that is not needed.

Treatment for ME will depend on the underlying cause, but proper treatment often improves symptoms.

Encephalopathies can affect anyone, but they tend to be more common among older adults, especially those over the age of 65 years.

Let’s take a closer look at the different types of ME.

One cause of ME can be a lack of something necessary for healthy brain functioning.

This doesn’t necessarily mean that you’re not taking in enough nutrients. Instead, it could be that your body isn’t processing the nutrients, so your brain isn’t getting what it needs.

This can also happen indirectly, meaning that one of your organs isn’t working properly, which prevents it from helping your brain to function.

Some causes of ME that fall into this group include:

Alternatively, ME can be the result of having too much of something, such as toxins usually filtered out by your kidneys or liver. An illness in one of your organs can lead to chemical changes that then affect how your brain functions. Examples include:

A closely related condition called toxic-metabolic encephalopathy (TME) can also be the result of medications, alcohol, or illicit substances that disrupt how your metabolism functions.

An altered mental state is generally the first sign of ME. Symptoms are frequently sudden but might progress more slowly for some people. In some cases, symptoms might resolve on their own after a few hours, but this does not mean that the underlying issue has been cured, and you should still seek treatment.

The progression of symptoms will depend, in part, on the cause of your ME.

Cognitive symptoms of ME can include:

You might also notice some symptoms of ME in other parts of your body besides your brain. These symptoms can include:

When to contact a doctor

ME is a serious medical condition. It may be due to severe issues in your brain or other vital organs.

The symptoms of ME also overlap with those of time-sensitive medical emergencies such as stroke.

If you’re experiencing sudden and unexplained symptoms of ME, seek medical attention immediately.

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Doctors may suspect you have ME based on some of the more outwardly visible symptoms. But usually, they’ll perform testing to confirm the diagnosis.

If a doctor believes you might have ME, you can expect to undergo blood tests.

An arterial blood gas test can quickly inform doctors about how much oxygen and carbon dioxide are in your blood and, therefore, might be supplied to your brain. It can also provide information about glucose and relevant electrolytes like sodium and potassium.

A doctor might also order a comprehensive metabolic panel to assess kidney and liver function, see if a pH imbalance indicates the presence of certain toxins, or check electrolyte levels. Too little or too much of various compounds could point to different causes of ME.

You might also need to undergo other tests, including:

The treatment you receive for ME will depend on the underlying cause.

If the cause of the ME isn’t known yet, a doctor will first treat your symptoms. This could include avoiding fever and controlling your electrolyte levels and blood pressure.

For some people, dietary changes such as taking supplements may be enough to treat ME and prevent reoccurrence.

For others, ME may be due to organ dysfunction or failure, which might require dialysis or transplant surgery.

As with treatment, the outlook for ME will depend on the cause and how quickly you start treatment.

Sometimes, ME goes away, and all normal functioning returns after treatment of the underlying cause. But if ME causes damage to your brain, it could be permanent or even fatal.

Doctors sometimes use the Glasgow Coma Scale (GCS) to measure impaired consciousness. The scale goes from 0 to 15. Higher GCS scores might be linked to better outcomes if you have ME, but this can vary from person to person.

There are many types of metabolic encephalopathies, but all are types of brain dysfunction that stem from your metabolism.

Many things can disturb your metabolism, ranging from vitamin deficiencies to organ failure.

Treatment and long-term outcomes will depend on the cause and how quickly you receive medical care. While it’s possible to reverse ME symptoms, they can sometimes be permanent.