About Physiatry

About Physiatry

Do you work with an institution or company looking to learn more about Physiatry?

Learn more about partnerships with AAPM&R.

Metabolic Encephalopathies

Condition: Metabolic encephalopathies (ME) are disorders where medical problems such as blood infections or liver or kidney failure cause brain damage.

Background: Severe illnesses that affect many systems in the body may cause ME. Older age and cognitive impairment may increase the risk. Low blood sugar or not enough vitamin B1 (thiamine) can also cause ME.      

History and Symptoms: Symptoms usually, but not always, come on suddenly. Patients may be confused, uncooperative, and have low energy. With chronic diseases, the symptoms may come on gradually.

Physical Exam: The doctor will check all of the body’s basic functions such as temperature, heart rate, breathing, and blood pressure. He will also check the eyes, and watch and listen to the patient to find out if there are problems with thinking, behavior, and mood, or physical problems like tremors.

Diagnostic Process: Tests of the blood, urine, and spinal fluid are used to show which systems in the body are having problems. High levels of ammonia in the blood suggest ME. Blood tests may also show if there is an infection or if there are drugs or toxins in the blood. CT or MRI may be used to rule out a stroke or other problem.

Rehab Management: The first step is treating the disease that caused ME. Drugs may be given for agitation. If the patient is in the hospital, the medical team will try to keep the patient moving as much as possible so he does not get bed sores or muscle weakness. Other types of treatment may be needed, such as physical therapy and mental health counseling.

Other Resources for Patients and Families: Families can help with both short-term and long-term care to keep ME from coming back and help the patient cope with problems.  

For Patients and Families:

View all Conditions & Treatments
Learn more about Physiatry

Find a Physician


Read the full PM&R Knowledge NOW® article at:

PM&R Knowledge NOW® Authors Needed

Participate in the development of PM&R Knowledge NOW® by applying to be an author of a 1,700-word summary of a clinical topic.

View a list of available topics and learn more about how to apply. Volunteering your time and expertise to is a great way to get published and recognized among your peers as a participant in this ground-breaking initiative!