Mental status impairment in patients with West Haven grade zero hepatic encephalopathy: the role of HCV infection

Citro, Vincenzo; Milan, Graziella; Tripodi, Francesca S.; Gennari, Antonio Giulio; Sorrentino, Paolo; Gallotta, Giovanni; Postiglione, Alfredo; Tarantino, Giovanni

doi:10.1007/s00535-006-1978-8

Cited by 25 publications

(30 citation statements)

References 9 publications

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“…When applying PREPs, which are in fact vertex responses, in a clinical setting, some authors fail to discuss the possible role of cognitive factors influencing the vertex response. In HCV patients, an early significant impairment of higher cognitive function has been demonstrated and its role in producing PREP abnormalities cannot be excluded [6]. Regarding these possible limitations of vertex potentials for analysing peripheral pathways, the investigations of Rossi et al [28] are of outstanding importance to the validation of our study.…”

Section: Discussionmentioning

confidence: 96%

Sensory neuropathy in patients with cryoglobulin negative hepatitis-C infection

et al. 2010

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There is growing evidence that hepatitis-C virus (HCV) infection might cause peripheral neuropathy. We aimed to investigate the prevalence, clinical and electrophysiological features of sensory neuropathy in patients with cryoglobulin negative HCV infection. We studied 46 consecutive cryoglobulin negative HCV positive patients (24 of them with and 22 without neuropathic symptoms, NS) and compared to 28 age and gender matched controls. In all patients and controls, clinical neuropathy symptom (NSS) and neuropathy deficit scores (NDS) were assessed and standard nerve conduction velocity (SNCV) and pain related-evoked potentials (PREP) were recorded. Both, SNCV and PREP were abnormal in 13 NS positive patients (13/46, 28%). Abnormal PREP but normal SNCV were found in 5 (5/46, 11%) NS positive and in 2 NS negative patients (2/46, 4%). PREP abnormalities correlated positive with both clinical neuropathy scores (NSS r=0.62; p<0.001; NDS r=0.57; p<0.001), but not with the duration of the disease, current viral load, or the virus subtype. PREP abnormalities were more frequent (16/33, 48.5%) in HCV patients treated with interferon than in therapy naïve patients (4/13, 30.8%); the difference was, however, not significant. In our present study (1) all virus subtypes are capable of inducing neuropathy, (2) no differences were found between interferon therapy and treatment naive patients, (3) the prevalence of peripheral sensory neuropathy including small sensory fibers (20/46, 43.5%) is higher than previously reported and (4) we found that detection of HCV associated neuropathy depends on the evaluation method.

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Section: Discussionmentioning

confidence: 96%

Sensory neuropathy in patients with cryoglobulin negative hepatitis-C infection

et al. 2010

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“…Patients with specific etiologies of cirrhosis are more likely to exhibit psychometric impairment, specifically chronic hepatitis C. Investigations in the chronic hepatitis C infected groups (both with and without cirrhosis) show a worse psychometric performance compared to patients without chronic hepatitis C in selected studies [30][31][32][33] . However, other studies have not demonstrated a difference in psychometric performance of cirrhotics with chronic hepatitis C compared to those without it [30,34] .…”

Section: Contribution Of Concomitant Diseases To Mhementioning

confidence: 99%

Minimal hepatic encephalopathy matters in daily life

Bajaj

2008

WJG

139

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Minimal hepatic encephalopathy is a neuro-cognitive dysfunction which occurs in an epidemic proportion of cirrhotic patients, estimated as high as 80% of the population tested. It is characterized by a specific, complex cognitive dysfunction which is independent o f s l e e p d y s fu n c t i o n o r p ro b l e m s w i t h ove ra l l intelligence. Although named "minimal", minimal hepatic encephalopathy (MHE) can have a far-reaching impact on quality of life, ability to function in daily life and progression to overt hepatic encephalopathy. Importantly, MHE has a profound negative impact on the ability to drive a car and may be a significant factor behind motor vehicle accidents. A crucial aspect of the clinical care of MHE patients is their driving history, which is often ignored in routine care and can add a vital dimension to the overall disease assessment. Driving history should be an integral part of care in patients with MHE. The lack of specific signs and symptoms, the preserved communication skills and lack of insight make MHE a difficult condition to diagnose. Diagnostic strategies for MHE abound, but are usually limited by financial, normative or time constraints. Recent studies into the inhibitory control and critical flicker frequency tests are encouraging since these tests can increase the rates of MHE diagnosis without requiring a psychologist. Although testing for MHE and subsequent therapy is not standard of care at this time, it is important to consider this in cirrhotics in order to improve their ability to live their life to the fullest.

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“…The most widely used method of grading HE is the West Haven Criteria (WHC) [ 24,25 ] , which is determined by clinical examination and based on the subjective evaluation of the clinician (see Table 29.2 ). This method has been criticized for lack of sensitivity to detect subtle brain dysfunction [ 26 ] . Neuropsychological or neurophysiological measures are recommended to identify less severe stages of HE [ 7,27 ] .…”

Section: Classi Fi Cation and Grading Of Hementioning

confidence: 99%

Hepatic Encephalopathy

Hilsabeck

Webb

2012

Handbook on the Neuropsychology of Aging and Dementia

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Hepatic encephalopathy (HE) is a metabolically-induced, usually reversible neuropsychiatric syndrome that results in signi fi cant morbidity and mortality. The incidence is unknown, but it is estimated that most individuals with cirrhosis develop some degree of HE, and advanced age is a risk factor. Cognitive, behavioral, and motor dysfunction are the characteristic features, although the pattern and severity differ among grades. Neuropsychologists are most likely to encounter HE in the context of liver transplant evaluations. The current chapter reviews the classifi cation and pathogenesis of HE, diagnosis and treatment considerations, and also provides a clinical case example and reviews practical issues that will arise for neuropsychologists involved in the care of patietns with HE.

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Mental status impairment in patients with West Haven grade zero hepatic encephalopathy: the role of HCV infection

Cited by 25 publications

References 9 publications

Sensory neuropathy in patients with cryoglobulin negative hepatitis-C infection

Sensory neuropathy in patients with cryoglobulin negative hepatitis-C infection

Minimal hepatic encephalopathy matters in daily life

Hepatic Encephalopathy

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