Abstract
The central nervous system in 8 out of 18 cases of severe liver disease revealed extensive alterations. The changes involved all regions of the brain and consisted of nerve cell damage and widespread areas of demyelination. The tissue alterations were predominantly perivascular in nature, suggesting a toxic etiology. From a review of the literature and a study of these cases it is felt that the liver damage enables some endogenous toxin to reach the brain and produce widespread damage.