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15411

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

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Last updated: 24 Dec 2024

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Abstract

Background: Minimal Hepatic Encephalopathy (MHE) is characterized by mild cognitive impairment, attention deficits, psychomotor slowing and impaired vasomotor and bimanual coordination. These non-evident 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.

DOI

10.21608/ejhm.2018.15411

Keywords

Cirrhosis of liver, psychometric tests, Electroencephalogram, visual evoked potential, Minimal hepatic encephalopathy

Authors

First Name

Assem Mahmoud

Last Name

El-Sherif

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Affiliation

Department of Internal Medicine, Faculty of Medicine, Al-Azhar University

Email

assem@gmail.com

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First Name

Fathy Ghamry

Last Name

Abdelrazik

MiddleName

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Affiliation

Department of Internal Medicine, Faculty of Medicine, Al-Azhar University

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Orcid

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First Name

Ahmed Elwassief

Last Name

Helal

MiddleName

-

Affiliation

Department of Internal Medicine, Faculty of Medicine, Al-Azhar University

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Orcid

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First Name

Ahmed Essmet

Last Name

Ali

MiddleName

-

Affiliation

Department of Neurology,Faculty of Medicine, Al-Azhar University

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Orcid

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First Name

Mohamed Mahmoud

Last Name

Abdelsayed

MiddleName

-

Affiliation

Department of Internal Medicine, Faculty of Medicine, Al-Azhar University

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Volume

73

Article Issue

4

Related Issue

2821

Issue Date

2018-10-01

Receive Date

2018-10-01

Publish Date

2018-10-01

Page Start

6,541

Page End

6,554

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_15411.html

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https://ejhm.journals.ekb.eg/service?article_code=15411

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25

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

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

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Article

Created At

22 Jan 2023