Minimal hepatic encephalopathy: A review

Nardone, Raffaele; Taylor, Alexandra; Höller, Yvonne; Brigo, Francesco; Lochner, Piergiorgio; Trinka, Eugen

doi:10.1016/j.neures.2016.04.009

Cited by 61 publications

(64 citation statements)

References 103 publications

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“…We found that MHE was present in 36% -51% which is close to the esults of previous studies that reported that the prevalence of MHE is high in patients with cirrhosis of liver and varies between 30% and 84% [3]. In addition Nardone et al reported that MHE is the earliest form of hepatic encephalopathy and can affect up to 80% of patients with liver cirrhosis [30].…”

Section: Mhe Impairs Patient's Daily Functioning and Quality Of Lifesupporting

confidence: 89%

Does Rifaximin Improve EEG and VEP in Egyptian Cirrhotic Patients with Minimal Hepatic Encephalopathy?

Abdelfattah¹,

Mohamed²,

Fawi³

et al. 2018

OJGas

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Background: Minimal hepatic Encephalopathy (MHE) is defined as HE without symptoms on clinical/neurological examination, but with deficits in some cognitive areas that can only be measured by neuropsychometric testing. However, numerous studies have shown that, although the neurological symptoms are slight, affected patients are markedly impaired in their quality of life and ability to work. Various treatment modalities that have been shown to reverse MHE include lactulose/lactitol, probiotics/synbiotics, L-carnitine but rifaximin has shown a general trend toward better efficacy and better tolerability in patients with overt hepatic encephalopathy (OHE). Objective: Our objective is to assess the diagnostic role of minimental state examination (MMSE), electroencephalography (EEG) and visual evoked potential (VEP) in detection of MHE and to evaluate the efficacy of rifaximin in improving EEG and VEP in patients with MHE. Patients and Methods: Sixty cirrhotic patients were enrolled in the study depending on clinical evidence of stigmata of chronic liver disease, laboratory investigations including liver function tests, ultrasonographic features of liver cirrhosis and with no evidence of overt hepatic encephalopathy. Diagnois of MHE was made depending on minimental state examination (MMSE) and neurophysiological tools including EEG and VEP. A control group of sixty healthy volunteers with age and sex matched were included. The patient group received Rifaximin 550 mg twice daily for 8 weeks then follow up EEG and VEP studies were done. Results: MHE was detected in 36.7%, 48.3%, 51.7% of our series based on MMSE, EEG and VEP respectively. Child Pouph A, B, C was found in 51.7%, 35%, 13.3% respectively. Rifaximin was well tolerated. At the end of treatment, How to cite this paper: Abdelfattah, A.M., Mohamed, A.-A.B., Fawi, G., Ragab, B., Elnady, H.M. and Malak, M. (2018) Does Rifaximin Improve EEG and VEP in Egyptian Cirrhotic Patients with Minimal Hepatic Encephalopathy? Open Journal of Gastroenterology, 8, 362-376.EEG and VEP studies were done which showed signficant changes between pre and post treatment results (P value = 0.03, 0.001, <0.001). Conclusion: MMSE as well as EEG and VEP were reasonable diagnostic tools for early detection of MHE particularly in countries with low level of education. Rifaximin significantly improves both EEG and VEP in cirrhotic patients with MHE.

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Section: Mhe Impairs Patient's Daily Functioning and Quality Of Lifesupporting

confidence: 89%

Does Rifaximin Improve EEG and VEP in Egyptian Cirrhotic Patients with Minimal Hepatic Encephalopathy?

Abdelfattah¹,

Mohamed²,

Fawi³

et al. 2018

OJGas

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“…Für Patienten mit mHE wurden eine Vielzahl von Nachteilen mit Auswirkungen auf Prognose, Mortalität, Lebensqualität, Übergang in eine manifeste HE, Fallneigung und Fahrvermögen [718,719] berichtet. Es gibt zahlreiche Tests zum Nachweis einer mHE, die allerdings wenig standardisiert sind und nicht immer zur gleichen Aussage führen.…”

Section: Therapie Bei Mheunclassified

Aktualisierte S2k-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) „Komplikationen der Leberzirrhose“

et al. 2019

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ZusammenfassungDie Leitlinie Komplikationen der Leberzirrhose der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) ersetzt die Leitlinie aus dem Jahr 2011. Sie basiert auf den Empfehlungen der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) für eine evidenzbasierte Konsensus-Leitlinie der Entwicklungsstufe S2k und wurde interdisziplinär unter Beteiligung aller relevanten Fachgesellschaften und der Patientenvertretung erstellt. Neben den in der Vorgängerversion behandelten Kapiteln Aszites, spontan bakterielle Peritonitis, hepatorenales Syndrom, hepatischer Hydrothorax und hepatopulmonales Syndrom wurden die Kapitel Diagnostik und Therapie der Hepatischen Enzephalopathie neu aufgenommen.

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“…5). Diese kognitiven Störungen betreffen Aufmerksamkeit, Vigilanz und integrative Funktionen und definieren bei gleichzeitigem Fehlen von klinischen Zeichen die mHE [19].…”

Section: Psychometrische Tests Und Mheunclassified

Hepatische Enzephalopathie

Holstege¹

2017

Gastroenterologie up2date

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Minimal hepatic encephalopathy: A review

Cited by 61 publications

References 103 publications

Does Rifaximin Improve EEG and VEP in Egyptian Cirrhotic Patients with Minimal Hepatic Encephalopathy?

Does Rifaximin Improve EEG and VEP in Egyptian Cirrhotic Patients with Minimal Hepatic Encephalopathy?

Aktualisierte S2k-Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) „Komplikationen der Leberzirrhose“

Hepatische Enzephalopathie

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