Question(s) about elevated ammonia levels

Raven · 03-06-2009, 07:19 PM

At what level would a patient's ammonia need to be before causing any brain damage, and how much of that damage could be reversible? Also how can a person tell when the level is rising? If damage has happened, can it be treated in any way to minimize? How can you tell without any testing if damage has occurred?

Any help/answers would be appreciated. Thank you.

Raven

noryn · 03-06-2009, 07:31 PM

I don't know that there is an exact answer. Usually your ammonia level isnt just elevated, most of the time there is another problem such as liver failure. Generally with a high ammonia level you begin to become confused. Once you have brain damage from anything, it just depends on the extent of the damage. The most important thing to do is to decrease the ammonia level as soon as possible, this will likely limit the damage.

Again it depends on what part of the brain was damaged as to what effects will be shown.

SCI-Nurse · 03-07-2009, 08:32 AM

Hi,

Here is a comprehensive review of encephalopathy, the term to which I believe you are referring. If you google search this, you will find a wealth of information.
http://emedicine.medscape.com/article/186101-overview

This covers treatment which usually includes diet (avoiding high protein foods), lactulose and other vitamin recommendations.

Rising ammonia levels are usually suggested when a person with cirrhotic liver disease becomes mentally confused or changed from their baseline. A recommended ammonia level to maintain is usually suggested by a heptologist based on their disease and individual factors. For most clinicians in primary care, ammonia levels are checked on a regular schedule and monitored in conjunction with liver enzymes, liver ultrasounds and the patients clinical picture. WE do not do any regularly scheduled brain testing, though specialists may have a different monitoring approach.

AAD

03-06-2009, 07:19 PM	#1
Raven Senior Member Join Date: Jul 2001 Location: Earth Posts: 3,089	Question(s) about elevated ammonia levels At what level would a patient's ammonia need to be before causing any brain damage, and how much of that damage could be reversible? Also how can a person tell when the level is rising? If damage has happened, can it be treated in any way to minimize? How can you tell without any testing if damage has occurred? Any help/answers would be appreciated. Thank you. Raven

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03-06-2009, 07:31 PM	#2
noryn Senior Member Join Date: Mar 2006 Posts: 353	I don't know that there is an exact answer. Usually your ammonia level isnt just elevated, most of the time there is another problem such as liver failure. Generally with a high ammonia level you begin to become confused. Once you have brain damage from anything, it just depends on the extent of the damage. The most important thing to do is to decrease the ammonia level as soon as possible, this will likely limit the damage. Again it depends on what part of the brain was damaged as to what effects will be shown.

03-07-2009, 08:32 AM	#3
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,515	Hi, Here is a comprehensive review of encephalopathy, the term to which I believe you are referring. If you google search this, you will find a wealth of information. http://emedicine.medscape.com/article/186101-overview This covers treatment which usually includes diet (avoiding high protein foods), lactulose and other vitamin recommendations. Rising ammonia levels are usually suggested when a person with cirrhotic liver disease becomes mentally confused or changed from their baseline. A recommended ammonia level to maintain is usually suggested by a heptologist based on their disease and individual factors. For most clinicians in primary care, ammonia levels are checked on a regular schedule and monitored in conjunction with liver enzymes, liver ultrasounds and the patients clinical picture. WE do not do any regularly scheduled brain testing, though specialists may have a different monitoring approach. AAD