Blood ammonia in cerebral dysfunction

NTEREST in the concentration of ammonia in the blood and its relation to neuropsychiatric disturbances has largely centered about liver disease. The identification of ammonia as the presumptive cause of the meat intoxication syndrome of Eck fistula dogs [I] has been followed by the repeated demonstration of abnormal blood ammonia levels in cirrhotic patients. Recent investigations indicating the presence of abnormal ammonia concentrations in nonhepatic diseases [2,3], as well as the importance of non-hepatic sources of ammonia [4], warrant a further consideration of the relation of ammonia to cerebral function. It was the purpose of this investigation to study the venous blood ammonia level in patients with Laennec’s cirrhosis and its various complications, including hepatic coma, and in patients with various nonhepatic disease entities with and without coma.