Diagnosis of Minimal Hepatic Encephalopathy of Cirrhotic Patients Using a Combination of Neuropsychiatric and Neurophysiological Tests.

Background: Minimal Hepatic Encephalopathy (MHE) is characterized by mild cognitive impairment, attention deficits, psychomotor slowing and impaired vasomotor and bimanual coordination. These nonevident symptoms can be revealed with neuro psycho metric and neuro physiological testing. Aim: to validate a comprehensive set of neuropsychiatric test battery in addition to the neuro physiological tests in detecting MHE. Patients and Methods: Thirty patients with liver cirrhosis and no clinical evidence of HE were selected for this study. Patients underwent laboratory screening, Neuropsychiatric and Neuro physiological tests. Results: Impairment of at least one psychometric test was documented in 50% of patients, with 50% abnormal NCTA, 46.7% abnormal DST and 40% abnormal LTT. VEP records showed prolonged P100 in 46.7% of patients with 40% prolongation of P100 in the right eye and 46.7% in the left eye. EEG recording was abnormal in 43.3% patients and the recorded abnormalities included; slow theta waves in 33% of patients, slow delta waves 10%, and 56% had normal EEG. Conclusion: The incidence of MHE can vary according to the strategy of diagnosis and while strict dependence on neuropsychiatric tests can diagnose MHE in 50% of patients, adopting a more strict policy that incorporate neuro physiological tests can limit the diagnosis 40% of patients. There is moderate concordance between neuropsychiatric and neurophysiologic tests. [ABSTRACT FROM AUTHOR]

Copyright of Egyptian Journal of Hospital Medicine is the property of Egyptian Journal of Hospital Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)