TITLE

Minimal hepatic encephalopathy and extrapyramidal signs in patients with cirrhosis

AUTHOR(S)
Jover, Rodrigo; Compañy, Luís; Gutiérrez, Ana; Zapater, Pedro; Pérez-Serra, Juan; Girona, Eva; Aparicio, José R.; Pérez-Mateo, Miguel
PUB. DATE
July 2003
SOURCE
American Journal of Gastroenterology;Jul2003, Vol. 98 Issue 7, p1599
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
: ObjectivesTwo types of neurological dysfunction can occur in compensated cirrhosis: 1) extrapyramidal signs related to the accumulation of manganese in the basal ganglia and 2) milder degrees of cognitive impairment known as minimal hepatic encephalopathy (mHE). We assessed whether there was any relationship between both disorders in 42 patients with compensated cirrhosis.: MethodsMinimal hepatic encephalopathy was diagnosed using a battery of manual neuropsychological tests. Cognitive functioning was assessed by the Mini-Mental State Examination. Extrapyramidal signs were evaluated by the Columbia scale.: ResultsMinimal hepatic encephalopathy was diagnosed in 15 (35.7%) patients. A total of 52.4% of patients showed significant extrapyramidal signs. Scores for the Columbia scale were higher in the presence of mHE (mean ± SD, 16.0 ± 10.9 vs 5.3 ± 7.1, p = 0.0004). In the bivariate analysis, mHE, Child-Pugh score, and Mini-Mental State Examination score were significantly associated with extrapyramidal signs, whereas in the multivariate analysis, mHE was the only independent variable related to extrapyramidal signs.: ConclusionsThere was a link between extrapyramidal signs and diagnosis of mHE based on manual neuropsychological testing. This finding may be explained by the influence of extrapyramidal manifestations on test performance or by a real pathophysiological relationship between both disorders. Further studies are necessary to resolve this question.
ACCESSION #
10234254

 

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