In the LOLA group, an improvement of posturographic control and PSE Syndrome Test was observed, but a similar improvement was also achieved by the placebo. In LOLA, ammonia levels tended to decrease while they tended to increase in the placebo group. LOLA might augment the improvement achieved by intravenous fluids alone but a larger cohort will be needed to show this effect with statistical significance.

Patients with cirrhosis have an impaired postural control compared with controls and this impairment deteriorates with progression of liver disease. HE as well as past alcohol abuse contribute to the pathogenesis of ataxia in liver cirrhosis and past alcohol abuse leads to an earlier and more pronounced manifestation of ataxia in the affected patients.

In this randomized-controlled trial, a preprocedure atropine injection did not prevent the occurrence of bradyarrhythmias. Prophylactic use of atropine might not be effective and therefore cannot be recommended as a routine procedure. Clinicaltrials.gov-identifier: NCT00575523.