Hepatic myelopathy after splenorenal shunting: report of one case and review of the literature.
Hepatic myelopathy is a rare complication of cirrhosis, usually associated with surgical or spontaneous porto-systemic shunts. Its pathophysiology is unknown. It is characterized by a motor involvement of the lower limbs without clinical sensory abnormality, leading to spastic paraparesis. These neurological features are related to a symmetric loss of myelin in the lateral corticospinal tracts. Usefulness of liver transplantation in this setting is not yet determined. We describe here the case of a 29-year-old male who presented with progressive spastic paraparesis of the lower limbs 3 years after a spleno-renal shunt.
Yengue
P
P
Medico-surgical Department of Gastroenterology, Université Libre de Bruxelles, Brussels, Belgium.
Adler
M
M
Bouhdid
H
H
Mavroudakis
N
N
Gelin
M
M
Bourgeois
N
N
D000328:Adult; D006501:Hepatic Encephalopathy / Q000150:complications; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D020336:Paraparesis, Spastic / Q000209:etiology*; D013164:Splenorenal Shunt, Surgical / Q000009:adverse effects*