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Description
Such circulating inflammatory factors may act as systemic mediators

WilmanskiTRappaportNEarlsJCMagisATManorOLovejoyJet al

Schulman, S

Theriogenology, 82(1), 95-103

Diagnosis To diagnose CHE, the patient must have 1) a disease that can lead to CHE, such as liver cirrhosis or a portosystemic shunt, 2) no other neurological disease, 3) no neurological manifestation such as disorientation or asterixis, and 4) abnormal cognitive or neurophysiologic functioning