Neuropsychological impairment in severe acute viral hepatitis is due to minimal hepatic encephalopathy

Liver International : Official Journal of the International Association for the Study of the Liver
Praveen SharmaShiv Kumar Sarin

Abstract

Minimal hepatic encephalopathy (MHE) in patients with liver cirrhosis may have prognostic significance with regard to the development of clinical hepatic encephalopathy (HE) and deterioration in patient quality of life. Its prevalence in acute viral hepatitis (AVH) is not known. Consecutive 20 AVH patients (age, 29.9+/-7.9 years; M:F 18:2, hepatitis A:B:E: 2:16:2) without overt encephalopathy were evaluated for MHE and followed up. All patients underwent number connection tests - A and B, figure connection tests - A and B, digit symbol test and object assembly test and critical flicker frequency (CFF) at baseline and after the resolution of icterus. MHE was diagnosed if two or more psychometric tests were abnormal. Prevalence of MHE (n=5) was 25%, which resolved on follow-up during the anicteric resolution phase. Five (25%) patients had greater than two abnormal psychometry tests and four (20%) had CFF <38 Hz. CFF alone had sensitivity and specificity of 80 and 100%, respectively, in the diagnosis of MHE. There was significant difference in the performance of CFF during the icteric and resolution phase of AVH (40.6+/-3.4 vs 41.8+/-2.1 Hz, P=0.04). Arterial ammonia level were higher in patients with MHE compared with patients wi...Continue Reading

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Citations

Jul 3, 2010·Journal of Gastroenterology and Hepatology·Radha K DhimanUNKNOWN Indian National Association for Study of the Liver
Jun 17, 2009·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Radha K Dhiman, Yogesh K Chawla
Jun 20, 2009·Mycologia·Bruce W HornIgnazio Carbone

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