Electroencephalography in Patients With Cirrhosis

Marchetti, P.; D’Avanzo, Costanza; Orsato, Raffaele; Montagnese, Sara; Schiff, Sami; Kaplan, Peter W.; Piccione, Francesco; Merkel, Carlo; Gatta, Angelo; Sparacino, Giovanni; Toffolo, Gianna; Amodio, Piero

doi:10.1053/j.gastro.2011.06.085

Cited by 49 publications

(37 citation statements)

References 46 publications

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“…Of note, the only independent predictors of the EEG MDF were serum ammonia and Neurochem Res (2015) 40:265-273 269 sodium levels. These findings were confirmed, on principle, in a further study of their group in 175 patients published in 2011 [43]. It remains unclear from these data, if the findings relate to HE or to hyponatremia.…”

Section: Diagnosis Of Minimal Hesupporting

confidence: 59%

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Challenges in Diagnosing Hepatic Encephalopathy

Weißenborn

2014

Neurochem Res

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The term "hepatic encephalopathy" (HE) covers the neuropsychiatric syndrome associated with acute, chronic and acute-on-chronic liver disease (CLD). This paper deals with clinical features and diagnosis of HE in patients with liver cirrhosis and portal hypertension or porto-systemic shunts. The possible impact of concomitant disorders and the cirrhosis underlying liver disease upon brain function is described emphasizing the need of a detailed diagnostic work up of every individual case before diagnosing HE. Currently used methods for diagnosing minimal or covert hepatic encephalopathy are compared with regard to their sensitivity and specificity for diagnosing HE against the background of a multitude of concomitant disorders and diseases that could contribute to brain dysfunction.

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Section: Diagnosis Of Minimal Hesupporting

confidence: 59%

“…We saw an abnormally slowed EEG in 35 % of 26 patients with grade I HE, but in only 17 % of 84 patients without clinical signs of HE [42]. According to literature abnormal slowing of the EEG is present in 15-30 % of the patients with liver cirrhosis without clinical signs of HE [40][41][42][43][44][45].…”

Section: Diagnosis Of Minimal Hementioning

confidence: 63%

Challenges in Diagnosing Hepatic Encephalopathy

Weißenborn

2014

Neurochem Res

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“…This is clearly captured by quantitative EEG, which does not detect a reduction in the mean dominant frequency (MDF) of the EEG in, but only an increase of theta activity in the posterior areas of the scalp. 7,[13][14][15] The MDF is a measure of the overall frequency of an EEG interval (called epoch) and, on the computational point of view, is the mean power of each frequency weighted by the frequency rate, according to the formula:…”

Section: The Typical Eeg Findings In Hementioning

confidence: 99%

Clinical Neurophysiology of Hepatic Encephalopathy

Amodio

Montagnese

2015

Journal of Clinical and Experimental Hepatology

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Background/Objectives: Hepatic encephalopathy (HE) has relevant impact on the quality of life of patients and their caregivers and causes relevant costs because of hospitalizations and work days lost. Its quantification is important to perform adequate clinical trials on this relevant complication of cirrhosis and portal-systemic shunting. Clinical neurophysiology, which detects functional alterations of the nervous system, has been applied to the study of HE for over 60 years. This review aims at summarizing and clarifying the role of neurophysiologic techniques in the study of HE. Methods: A narrative review was performed aiming at interpreting the cited papers and the techniques on the basis of their physiological and pathophysiological meaning. Results: The potential role of EEG, quantified EEG, evoked potentials-both exogenous, endogenous and motor-have been clarified to the reader that may be unfamiliar with neurophysiology. Conclusions: The EEG, reflecting the oscillatory changes of neural network is the preferable tool to detect and monitor HE, with the exception of its most severe stage, when EEG flattens. SSEP and MEP have indication to detect and monitor transmission alterations that are likely related to myelin changes and microedema. ( J CLIN EXP HEPATOL 2014;5:S60-S68)

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“…Neurophysiologic studies have demonstrated that HE causes reduction of the oscillatory properties of neural networks [110,111] with movement of EEG alpha frequencies from the posterior cortical areas to the anterior ones (frontal cortex) in mild HE [112], and occurrence of triphasic waves in severe HE [67].…”

Section: Organ Levelmentioning

confidence: 99%