title: Liver transplantation improves hepatic myelopathy: evidence by three cases.
abstract: OBJECTIVE
  Hepatic myelopathy is a rare complication of chronic liver disease, causing progressive spastic paraparesis. Today, no therapy of this disorder has been established. Commonly used therapeutic strategies for hepatic encephalopathy aiming at the reduction of plasma ammonia levels such as protein restriction, oral neomycin, lactulose, or ornithine aspartate fail to improve the symptoms of hepatic myelopathy. The aim of this study was to find out whether orthotopic liver transplantation (OLT) may improve hepatic myelopathy.
  
  
  METHODS
  Follow-up examinations of 3 patients with severe hepatic myelopathy before and after OLT.
  
  
  RESULTS
  In all 3 patients, the neurologic status improved significantly after liver transplantation. The grade of improvement was related to the time interval between onset of the first symptoms of hepatic myelopathy and liver transplantation.
  
  
  CONCLUSIONS
  Early recognition of hepatic myelopathy is important because timely liver transplantation as an established therapy for end-stage liver disease offers the chance of complete recovery from hepatic paraparesis.
authors.affiliation: Department of Neurology, Medizinische Hochschule Hannover, Germany. Weissenborn.Karin@mh-hannover.de
authors.forename: Karin
authors.initials: K
authors.lastname: Weissenborn
authors.forename: Uwe J F
authors.initials: UJ
authors.lastname: Tietge
authors.forename: Martin
authors.initials: M
authors.lastname: Bokemeyer
authors.forename: Bahram
authors.initials: B
authors.lastname: Mohammadi
authors.forename: Ulriue
authors.initials: U
authors.lastname: Bode
authors.forename: Michael P
authors.initials: MP
authors.lastname: Manns
authors.forename: Martin
authors.initials: M
authors.lastname: Caselitz
mesh_terms: D000328:Adult; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D009420:Nervous System / Q000503:physiopathology; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome