CNS+Metabolic+Disturbances

FLuctuating attention Confusion Somnolence STupor asterixis...(flapping movements of hands)

unknow pathogensis... increase in ammonia and perhaps endogenous benzodiasepines

type to astrocyttes: enalrgedvesicular ucleus narginated chromatin

clincial sy

stain through base of pons.. dramatic neurodemelination don't correct hyponatremia too quickly