In the decompensated stage of liver disease, the liver becomes unable to break down and rid the body of ammonia
. Toxic levels
build in the blood and brain, causing a condition known as hepatic encephalopathy. Symptoms of this condition include behavior and personality changes, fatigue, drowsiness, slurred speech, confusion, disorientation and muscle twitching. In the last stage of hepatic encephalopathy, seizures, coma and death occur.