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Subclinical Hepatic Encephalopathy (subclinical + hepatic_encephalopathy)

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Medical Sciences	100%

Selected Abstracts

Subclinical hepatic encephalopathy: Elusive ,gold standard'

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2004
PARAMPREET S KHARBANDA
No abstract is available for this article. [source]

Electrophysiological and neuropsychological tests for the diagnosis of subclinical hepatic encephalopathy and prediction of overt encephalopathy

LIVER INTERNATIONAL, Issue 3 2002
Nandini Saxena
Abstract: Background: Subclinical hepatic encephalopathy (SHE) features in 30,84% of patients with cirrhosis of the liver. Its clinical significance with regards to progression to overt encephalopathy has however, not been established. Aims: The present study was conducted (i) to compare the diagnostic usefulness of neuropsychological tests with that of electrophysiological (EP) tests in detection of SHE, and (ii) to examine the natural course of SHE. Methods: Seventy-five-nonencephalopathic cirrhotics (11 females, 64 males; mean (± SD) age 43.6 (± 11.7) years; mean (± SD) education 11(± 3) years) were studied using a battery of tests for intelligence and memory, the number connection test (NCT), and EP tests viz. electroencephalogram (EEG) and auditory P300 event related potentials (P3ERP). All the patients were followed up for a period of 6 months to 2 years for development of overt encephalopathy. Results: Thirty-five out of 75(47%) patients were diagnosed to have SHE based on at least one abnormal test result. The P3ERP latencies detected SHE in maximum number of patients (23%) followed by EEG (21%). Nearly 59% of patients with SHE progressed to overt encephalopathy within a mean duration of 4 months. Multivariate analysis showed that prior episode of encephalopathy (RR = 6.3; 95% CI = 2.0,19.7), abnormality on EEG (RR = 7.5; 95% CI = 2.2,25.3), abnormal performance on psychometric battery of tests (RR = 35.2; 95% CI = 4.3,287.3), occurrence of gastrointestinal bleed (RR = 19.3; 95% CI = 4.1,88.9), occurrence of dehydration (RR = 10.7; 95% CI = 2.5,45.4) and infection (RR = 11.4; 95% CI = 2.0,64.4) had significantly higher risk for development of overt encephalopathy. Conclusions: EP methods were more sensitive in detection of SHE. Amongst all the tests used, presence of only an abnormal EEG was significantly associated with development of overt encephalopathy along with the precipitating factors. [source]

Value of regional cerebral blood flow in the evaluation of chronic liver disease and subclinical hepatic encephalopathy

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2003
YUSUF YAZGAN
Abstract Aims:, Regional changes in cerebral blood flow in patients with chronic hepatitis, cirrhosis and subclinical hepatic encephalopathy were investigated in the present study using single photon emission computed tomography (SPECT). Methods:, Twenty patients with cirrhosis, 11 patients with chronic hepatitis, and nine healthy controls were included in the study. Cerebral SPECT were obtained for all patients. The percentages of cerebral blood flow of 14 regions to the cerebellar blood flow were determined. Only the patients with cirrhosis underwent psychometric evaluation: visual evoked potentials (VEP) measurements and electroencephalogram (EEG) recordings along with blood levels of albumin, bilirubin, and ammonia were measured and prothrombin time was determined in cirrhotic patients. These patients were classified according to the Child,Pugh classification. Results:, Among cirrhotic patients, six had abnormal results in VEP studies, 11 in psychometric tests and with six in EEG evaluation. Any abnormality in psychometric tests and/or VEP studies is taken as the main criterion; subclinical hepatic encephalopathy was detected in 12 of 20 patients. According to SPECT results in patients with subclinical encephalopathy, a statistically significant decrease in cerebral blood flow in right thalamus and nearly significant decrease in left thalamus were observed. Regional blood flow was significantly higher in the frontal lobes of patients with cirrhosis when compared with healthy controls. Similarly, cerebral blood flow in frontal and cingulate regions was significantly higher in patients with chronic hepatitis than in healthy controls. There was no relationship between cerebral blood flow and blood levels of ammonia or Child,Pugh score, in cirrhotic patients. Conclusion:, Significant changes in cerebral blood flow may be present in chronic liver diseases and the authors suggest that the measurement of changes in cerebral blood flow might be useful in detecting subclinical hepatic encephalopathy. [source]