liver problems/ amonia(ammonia) on brain

my mother in law has liver damage, and ended up in the hospital having seizures, which the doctors have told us were caused by Amonia (ammonia) on the brain. She is home with us now and taking Laculose 10ml per day, and we are trying to reduce her proteins, but I am not sure how much to reduce them... Also she is in constant and extreme leg pain and I am wondering what can be done for the pain? She is a recovering alcoholic and has been clean quite a while now but the pain makes her very depressed...

[Thomas D Schiano, MD]

the leg pain may be due to peripheral neuropathy for which she should be seen by a neurologist for medical therapy.  If its cramping she can take some quinine water to prevent it from occurring.  Xifaxan is an alternative medication or adjunct to lactulose to treat hepatic encephalopathy.