2011, Number S2
<< Back Next >>
Ann Hepatol 2011; 10 (S2)
Minimal hepatic encephalopathy
Zamora NLE, Torre DA
Language: English
References: 35
Page: 50-54
PDF size: 718.48 Kb.
ABSTRACT
The term minimal hepatic encephalopathy (MHE) refers to the subtle changes in cognitive function, electrophysiological
parameters, cerebral neurochemical/neurotransmitter homeostasis, cerebral blood flow,
metabolism, and fluid homeostasis that can be observed in patients with cirrhosis who have no clinical
evidence of hepatic encephalopathy; the prevalence is as high as 84% in patients with hepatic cirrhosis.
Physician does generally not perceive cirrhosis complications, and neuropsychological tests and another
especial measurement like evoked potentials and image studies like positron emission tomography can only
make diagnosis. Diagnosis of minimal hepatic encephalopathy may have prognostic and therapeutic implications
in cirrhotic patients. The present review pretends to explore the clinic, therapeutic, diagnosis and
prognostic aspects of this complication.
REFERENCES
Lockwood A. Blood ammonia levels and hepatic encephalopathy. Metab Brain Dis 2004; 19: 345-8.
Bajaj J, Wade J, Sanyal A. Spectrum of neurocognitive impairment in cirrhosis: implications for the assessment of hepatic encephalopathy. Hepatology 2009; 50: 2014-21.
Romero-Gómez M, Grande L, Camacho I. Prognostic value of altered oral glutamina challenge in patients with minimal hepatic encephalopathy Hepatology 2004; 39: 939-43.
Bustamante J, Rimola A, Ventura P, Navasa M, Cirera I, Reggiardo V. Prognostic significance of hepatic encephalopathy in patients with cirrhosis. J Hepatol 1999; 30: 890-5.
Stewart C, Malinchoc M, Kim W, Kamath P. Hepatic encephalopathy as a predictor of survival in patients with endstage liver disease. Liver Transpl 2007; 13: 1366-71.
Prasad S, Dhiman R, Duseja A, Chawla Y, Sharma A, Agarwal R. Lactulose improves cognitive functions and healthrelated quality of life in patients with cirrhosis who have minimal hepatic encephalopathy. Hepatology 2007; 45: 549-59.
Ferenci P, Lockwood A, Mullen K, et al. Hepatic encephalopathy- definition, nomenclature, diagnosis, and quantification: Final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology 2002; 35: 716-21.
Amodio P, Montagnese S, Gatta A, et al. Characteristics of Minimal Hepatic Encephalopathy. Metab Brain Dis 2004; 19: 253-67.
Mattarozzi K, Stracciari A, Vignatelli L, et al. Minimal Hepatic Encephalopathy. Arch Neurol 2004; 61: 242-7.
Dhiman R, Chawla Y. Minimal hepatic encephalopathy. Indian J Gastroenterol 2009; 28: 5-16.
Dhiman R, Saraswat V, Sharma B, et al. Minimal hepatic encephalopathy: Consensus statement of a working party of the Indian National Association for Study of the Liver. J Gastroenterol Hepatol 2010; 25: 1029-41.
Montgomery JY, Bajaj JS. Advances in the evaluation and management of minimal hepatic encephalopathy. Curr Gastroenterol Rep 2011; 13: 26-33.
Mattarozzi K, Campi C, Guarino M, et al. Distinguishing between clinical and minimal hepatic encephalopathy on the basis of specific cognitive impairment. Metab Brain Dis 2005; 20: 243-9.
Ortiz M, Jacas C, Córdoba J. Minimal hepatic encephalopathy: diagnosis, clinical significance and recommendations. J Hepatol 2005; 42: S45-S53.
Córdoba J, Mínguez B. Hepatic encephalopathy. Sem Liv Dis 2008; 28: 70-80.
Weissenborn K, Ennen J, Schomerus H, et al. Neuropsychological characterization of hepatic encephalopathy. J Hepatol 2001; 34: 768-73.
Quero J, Herrería J. Diagnostic methods in hepatic encephalopathy. Clin Chim Act 2006; 365: 1-8.
Kircheis G, Wettstein M, Timmermann L, et al. Critical flicker frequency for quantification of low-grade hepatic encephalopathy. Hepatology 2002; 35: 357-66.
Romero-Gómez M, Córdoba J, Jover R, et al. Value of the critical flicker frequency in patients with minimal hepatic encephalopathy. Hepatology 2007; 45: 879-885.
Sharma P, Sharma BC, Puri V, et al. Critical flicker frequency: Diagnostic tool for minimal hepatic encephalopathy. J Hepatol 2007; 47: 67-73.
Randolph C, Hilsabeck R, Kato A, et al. Neuropsychological assessment of hepatic encephalopathy: ISHEN practice guidelines. Liver Int 2009; 29: 789-96.
Weissenborn K. PHES: One label, different goods? J Hepatol 2008; 49: 308-12.
Romero-Gómez M, Córdoba J, Jover R, et al. Normality tables in the Spanish population for psychometric tests used in the diagnosis of minimal hepatic encephalopathy. Med Clin 2006; 126: 246-9.
Amodio P, Campagna F, Olianas S, et al. Detection of minimal hepatic encephalopathy: Normalization and optimization of the Psychometric Hepatic Encephalopathy Score. A neuropsychological and quantified EEG study. J Hepatol 2008; 49: 346-53.
Marks M, Jackson C, Montagnese S, et al. Derivation of a normative UK database for the psychometric hepatic encephalopathy score (PHES): confounding effect of ethnicity and test scoring. J Hepatol 2008; 48: S119.
Dhiman R, Kurmi R, Thumburu K, et al. Diagnosis and prognostic significance of minimal hepatic encephalopathy in patients with cirrhosis of liver. Dig Dis Sci 2010; 55: 2381-90.
Das A, Dhiman R, Saraswat V, et al. Prevalence and natural history of subclinical hepatic encephalopathy in cirrhosis. J Gastroenterol Hepatol 2001; 16: 531-5.
Torre DA, Guerrero HI, Uribe M. Minimal hepatic encephalopathy: Characteristics, diagnosis, and clinical implications. Rev Gastroenterol Mex 2006; 71(1): 63-70.
Bajaj J. Minimal hepatic encephalopathy matters in daily life. World J Gastroenterol 2008; 14: 3609-15.
Sharma P, Sharma B, Puri V, Sarin S. Minimal hepatic encephalopathy in patients with extrahepatic portal vein obstruction. Am J Gastroenterol 2008; 103: 1406-12.
Groeneweg M, Moerland W, Quero J, et al. Screening of subclinical hepatic encephalopathy J Hepatol 2000; 32: 748-53.
Senzolo M, Amodio P, D’Aloiso M, et al. Neuropsychological and Neurophysiological evaluation in cirrhotic patients with minimal hepatic encephalopathy undergoing liver transplantation. Transplant Proc 2005; 37: 1104-7.
Meixuiero DA, Duarte RA, Uribe M, Torre DA. Prevalencia de encefalopatía hepática mínima en pacientes con cirrosis biliar primaria y la utilidad de la frecuencia de centelleo en su diagnóstico. Rev Gastroenterol Mex 2007; 2(Sup. 2): 351.
Butterworth RF. Altered glial-neuronal crosstalk: cornerstone in the pathogenesis of hepatic encephalopathy. Neurochem Int. 2010; 57(4):383-8. Epub 2010 Mar 27. Review.
Bajaj JS, Cordoba J, Mullen KD, Amodio P, Shawcross DL, Butterworth RF, Morgan MY. Review article: the design of clinical trials in hepatic encephalopathy-an International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) consensus statement. Aliment Pharmacol Ther 2011; 33: 739-47.