Latent portasystemic encephalopathy

Abstract

Forty patients with chronic liver disease and portal hypertension but without clinical signs of portasystemic encephalopathy (15 patients with nonalcoholic cirrhosis, 15 patients with alcoholic cirrhosis, and 10 patients with minimal EEG changes) and a control group of 12 patients with chronic alcohol pancreatitis were studied using an extensive psychometric program, which, in the same form, is used for expert reports on driving capacity. Of the cirrhotic patients, 60% were considered unfit to drive; in 25% driving capacity was questionable, 15% (only nonalcoholic cirrhotics) were considered fit to drive. In contrast 75% of the patients with alcoholic pancreatitis were considered fit to drive. Major defects were found only in three heavy alcoholics. Patients with alcoholic cirrhosis scored lower than patients with nonalcoholic cirrhosis. This was due to differences in liver function rather than to the effect of alcohol consumption. Patients with minimal EEG changes were practically all considered unfit to drive.

The Diagnosis of Subclinical Hepatic Encephalopathy in Patients With Cirrhosis Using Neuropsychological Tests and Automated Electroencephalogram Analysis

“…4,9,15 In view of the reported high incidence of according to the standard recommended procedure, in SHE in patients with cirrhosis and its possible impact on contrast only 7% of the patients had an abnormal NCT daily life, routine assessment of early stages of HE is recomwhen scores corrected for age were used. Combining the mended, 4,6,9,16 as this syndrome may be fully reversible with results of the spectral EEG and the psychometric tests treatment. 4,[17][18][19][20] However, the extensive neuropsychological corrected for age yielded a higher prevalence of SHE test batteries used in most studies (up to 21 different psycho-(23%) than when each test method was used alone (17% metric tests!…”

The diagnosis of subclinical hepatic encephalopathy in patients with cirrhosis using neuropsychological tests and automated electroencephalogram analysis

“…defects, yet have a normal mental and neurological status on One hundred and thirty-seven consecutive patients global clinical examination. [3][4][5][6][7][8][9][10][11][12][13] The prevalence of this subclin-(mean age 49 years, range 17-77) with cirrhosis without ical hepatic encephalopathy (SHE) has been reported to vary any clinical signs of encephalopathy, were screened for from 30% 13 to 84%, 11 depending on the tests and population SHE. In addition, the Child-Pugh score and the arterial used.…”

Hepatic Encephalopathy

“…The subcategories of episodic, persistent, and minimal are based partly on course and partly on severity of HE. Importantly, use of the term "subclinical" HE was discouraged due to concern that it trivialized the clinical signi fi cance of a condition with detrimental effects on ability to perform complex tasks like driving [8][9][10][11][12][13] , and health-related quality of life (HRQOL) [14][15][16][17] , and outcome [18][19][20][21][22][23] .…”