Neuropsychological assessment of hepatic encephalopathy: ISHEN practice guidelines

Liver International - Tập 29 Số 5 - Trang 629-635 - 2009
Christopher Randolph1, Robin C. Hilsabeck2, Ainobu Kato3, P Kharbanda4, Yuyuan Li5, Daniela Mapelli6, Lisa Ravdin7, Manuel Romero‐Gómez8, Andrea Stracciari9, Karin Weißenborn10
1Department of Neurology; Loyola University Medical Center; Maywood, IL USA.
2Department of Psychiatry, University of Texas Health Science Center and South Texas Veterans Health Care System, San Antonio, TX, USA
3Department of Internal Medicine, Iwate Medical University, Iwate, Japan
4Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
5Department of Gastroenterology, First Municipal People's Hospital of Guangzhou, Guangzhou, China
6Department of General Psychology, University of Padova, Padova, Italy
7Department of Neurology, Weill Cornell Medical Center, New York, NY, USA
8UGC Enfermedades Digestivas, Hospital Universitario de Valme, Sevilla, Spain
9Department of Neurology, S. Orsola-Malpighi Hospital, Bologna, Italy
10Department of Neurology, Medizinische Hochschule Hannover, Hannover, Germany

Tóm tắt

AbstractLow‐grade or minimal hepatic encephalopathy (MHE) is characterised by relatively mild neurocognitive impairments, and occurs in a substantial percentage of patients with liver disease. The presence of MHE is associated with a significant compromise of quality of life, is predictive of the onset of overt hepatic encephalopathy and is associated with a poorer prognosis for outcome. Early identification and treatment of MHE can improve quality of life and may prevent the onset of overt encephalopathy, but to date, there has been little agreement regarding the optimum method for detecting MHE. The International Society on Hepatic Encephalopathy and Nitrogen Metabolism convened a group of experts for the purpose of reviewing available data and making recommendations for a standardised approach for neuropsychological assessment of patients with liver disease who are at risk of MHE. Specific recommendations are presented, along with a proposed methodology for further refining these assessment procedures through prospective research.

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