Hepatic myelopathy with spastic paraparesis.
Progressive myelopathy is a rare neurological complication of chronic liver disease with portal hypertension and there is no special diagnostic tool for hepatic myelopathy. Neuropathological studies of the patients with hepatic myelopathy have demonstrated demyelination of the lateral corticospinal tracts with various degree of axonal loss. Transcranial magnetic stimulation (TMS) is widely utilized as an indicator of changes in excitability and conductivity of the motor pathways. TMS studies are also used for the diagnosis of hereditary spastic paraparesis in the literature. In this study, we described two patients who presented with spastic paraparesis; TMS studies suggested that they had myelopathy and diagnosed as hepatic myelopathy when all the other possible diagnoses were ruled out.
Utku
Ufuk
U
Univercity of Trakya Faculty of Medicine, Department of Neurology, Edirne 22030, Turkey.
Asil
Talip
T
Balci
Kemal
K
Uzunca
Ilkay
I
Celik
Yahya
Y
D000328:Adult; D001921:Brain / Q000473:pathology; D003711:Demyelinating Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D019054:Evoked Potentials, Motor / Q000502:physiology; D006501:Hepatic Encephalopathy / Q000175:diagnosis*; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation; D020336:Paraparesis, Spastic / Q000175:diagnosis*; D011712:Pyramidal Tracts / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology; D013118:Spinal Cord Diseases / Q000175:diagnosis*; D050781:Transcranial Magnetic Stimulation