Liver transplantation improves hepatic myelopathy: Evidence by three cases

Weißenborn, Karin; Tietge, Uwe J. F.; Bokemeyer, Martin; Mohammadi, Bahram; Bode, Ulrike; Manns, Michael P.; Caselitz, M

doi:10.1053/gast.2003.50062

Cited by 86 publications

(65 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…14 In a previous study by using fluid attenuated inversion recovery imaging, we found an increased T2 signal intensity in the corticospinal tract in approximately 25% of patients with cirrhosis. This abnormality, which is associated with functional impairment detected by neurophysiologic methods, probably corresponds to the same pathogenic syndrome as hepatic myelopathy, 37 but to a lesser extent. In comparison with the parietal white matter, the corticospinal tract showed an increase in fast and slow MD, which suggests coexistence of extracellular and intracellular edema.…”

Section: Discussionmentioning

confidence: 86%

“…The persistent isotropy (lower FA) in the corticospinal tract probably relates to microscopic structural changes, such as those caused by demyelination. 39 Myelin loss can explain the persistent functional derangement after liver transplantation in patients with welldefined hepatic myelopathy 37 and in those with T2 hyperintensity along the corticospinal tract. 38 One important result of our study is that introduction of a biexponential analysis-enabled detection of MD and FA changes that monoexponential analysis did not show, as can be seen in Figs 1-4.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Biexponential Analysis of Diffusion-Tensor Imaging of the Brain in Patients with Cirrhosis before and after Liver Transplantation

Chavarria¹,

Alonso²,

García-Martinez³

et al. 2011

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Biexponential Analysis of Diffusion-Tensor Imaging of the Brain in Patients with Cirrhosis before and after Liver Transplantation

Chavarria¹,

Alonso²,

García-Martinez³

et al. 2011

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…In particular, nitrogenous products such as ammonia have been identified as a major contributor to the development of HM. 17 Interestingly, Nardone et al 5 found that clinical and MEP results of patients with a more advanced stage of disease (with markedly prolonged CMCT) were not substantially altered by liver transplantation, whereas patients with strong evidence of early-stage disease (minor CMCT abnormalities) exhibited clear neurophysiological and clinical improvement after liver transplantation. These MEP findings suggest that HM may be reversible if treated in the early stages of the disease, 18,19 whereas spinal cord dysfunction remains unchanged or is less likely to be reversed by liver transplantation in the later stages.…”

Section: Discussionmentioning

confidence: 99%

Central motor and sensory conduction in patients with hepatic myelopathy

Nardone

Orioli²,

Höller

et al. 2014

Spinal Cord

View full text Add to dashboard Cite

Study design: Experimental neurophysiological study. Objectives: The hepatic myelopathy (HM) is characterized by progressive weakness and spasticity of the lower extremities, while there are only a few reports of sensory impairment. However, sensory function has been poorly explored in HM. We believe that an electrophysiological assessment of dorsal columns by somatosensory evoked potentials (SEPs) and of cortico-spinal lateral tracts by motor evoked potentials (MEPs) should be of considerable value in the functional evaluation of the spinal cord involvement in patients with HM. Setting: Salzburg (Austria) and Merano (Italy). Methods: Eight patients diagnosed with HM were studied with MEPs and SEPs. Neurological examination revealed different degrees of cortico-spinal tract involvement in all patients and sensory abnormalities in three patients. Results: Central motor conduction to lower limb muscles was abnormal in all patients, while central sensory conduction was abnormal in seven out of the eight patients. Both central motor and sensory conduction to upper limbs are normal in all patients. Conclusion:The main finding is that electrophysiological evidence of central sensory involvement is present in a very high percentage of patients with HM, and that the threshold for electrophysiological abnormalities is below that for clinical manifestations. Therefore, central sensory and motor conduction studies are sensitive methods for detecting, localizing and monitoring spinal cord damage in HM.

show abstract

“…33,36 Pathology Findings Neuropathologic studies show demyelination in the lateral corticospinal tracts with varying degrees of axonal loss. 33,37 Imaging Findings MRI usually shows symmetric high T2 signal intensity in the lateral corticospinal tracts and less commonly in the ventral pyramidal tracts, posterior columns, and spinocerebellar tracts.…”

Section: Clinical Presentationsmentioning

confidence: 99%

Toxic and Metabolic Myelopathies

Ramalho

Nunes

Rocha

et al. 2016

Seminars in Ultrasound, CT and MRI

View full text Add to dashboard Cite

Myelopathy describes any neurologic deficit related to the spinal cord. It is most commonly caused by its compression by neoplasms, degenerative disc disease, trauma, or infection. Less common causes of myelopathy include spinal cord tumors, infection, inflammatory, neurodegenerative, vascular, toxic, and metabolic disorders. Conditions affecting the spinal cord must be recognized as early as possible to prevent progression that may lead to permanent disability. Biopsy is rarely performed, thus the diagnosis and management rely on patient's history, physical examination, laboratory results, and imaging findings. Here we review the clinical presentations, pathophysiological mechanisms, and magnetic resonance imaging findings of myelopathies related to metabolic or toxic etiologies. Semin Ultrasound CT MRI 37:448-465 C 2016 Elsevier Inc. All rights reserved.

show abstract

Liver transplantation improves hepatic myelopathy: Evidence by three cases

Cited by 86 publications

References 21 publications

Biexponential Analysis of Diffusion-Tensor Imaging of the Brain in Patients with Cirrhosis before and after Liver Transplantation

Biexponential Analysis of Diffusion-Tensor Imaging of the Brain in Patients with Cirrhosis before and after Liver Transplantation

Central motor and sensory conduction in patients with hepatic myelopathy

Toxic and Metabolic Myelopathies

Contact Info

Product

Resources

About