Natural history of minimal hepatic encephalopathy in patients with extrahepatic portal vein obstruction

  • Sharma P
  • Sharma B
  • Puri V
 et al. 
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OBJECTIVES: Minimal hepatic encephalopathy (MHE) leads to deterioration in patient quality of life and could be a marker for future episodes of clinical hepatic encephalopathy (HE) in liver cirrhosis. Whether MHE predicts HE in extrahepatic portal vein obstruction (EHPVO) is not known. We studied the incidence of overt HE in EHPVO patients with MHE. METHODS: Consecutive patients (from October 2006 to July 2007) with a diagnosis of EHPVO were followed up at 3-month intervals. MHE was diagnosed by abnormal psychometry (>2 s.d.) and/or P300 auditory event-related potential (P300 ERP) (>2.5 s.d.), and HE was diagnosed as per West-Heaven criteria. Critical flicker frequency (CFF) was also measured at baseline and after 1 year.RESULTS:Thirty-two EHPVO patients (age, 23.2+/-10.8 years; M/F 22:10) were followed up for 1 year. Of 32 patients, P300 ERP was prolonged in 8 (25\%) (371.8+/-13.9 ms), 9 (28\%) had abnormal psychometric tests, and CFF was

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  • Praveen Sharma

  • Barjesh Chander Sharma

  • Vinod Puri

  • Shiv Kumar Sarin

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