Background: Cirrhosis is a dynamic process starts after sustained inflammation, followed by necrosis of liver cells and fibrosis that occur as a normal wound healing response then nodular formation that eventually lead to hepatic dysfunction. Aim and objectives: Study the effect of hepatic cirrhosis on cerebral cortex and subcortical pathways using VEP, and Comparison between different VEP check sizes in detection of early encephalopathy among cirrhotics. Subjects and methods: This was a case/control study carried out on 45 cirrhotic patients, and 45 matched normal controls. All subjects underwent full opthalmological assesment prio to the conduction of the PVEP, after the approval of the ethical committee. Results: the studied cases had significantly more delayed latency and lower amplitude than the studied controls on both sides at both 1 degree and 15 minutes check sizes (P-value<0.05), however 13 patiebts were detected by the 15 min check size to be abnormal on he contrary of the 1 degree chech size that detected changes only in 6 patients. Conclusion: Vep 15 min is more sensitive in detecting early changes in cirrhotic patients. denoting that most of the hepatic encephalopathy changes are affecting the central visual field.
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