[The role of neuropsychological testing and electroencephalogram for early detection of minimal hepatic encephalopathy].
OBJECTIVE
Minimal hepatic encephalopathy in patients with clinically asymptomatic chronic progressive liver disease may have adverse effects on daily activity. We evaluated the differences in the cognitive function of patients with chronic hepatitis and liver cirrhosis group according to the Child-Pugh classification.


METHODS
We enrolled 61 consecutive chronic liver disease patients. We used the following study instruments: visual continuous performance test, a spatial memory test, the Wisconsin card-sorting test chosen from Neuroscan and STIM system (Study of the Usefulness of Computerized Neuropsychological Test, Neurosoft company, New York, NY, USA), a global-local processing test and an electroencephalogram (EEG).


RESULTS
A significant correlation was found between neurologic abnormalities and the degree of liver disease. The result of the neuropsychological test and the EEG showed that cognitive function decreased according to the severity of chronic liver disease, especially in liver cirrhosis. Cirrhotic patients, especially in Child-Pugh C group, exhibited selective deficits in complex attention and fine motor skills as well as visual spatial perception, with preservation of memory.


CONCLUSIONS
The STIM and EEG are simple, subjective and reproducible methods and may be used as early detection methods of minimal hepatic encephalopathy.
Choi
Choon Shik
CS
Department of Internal Medicine, Hanyang University Medical College, Seoul, Korea.
Kim
Byung Ik
BI
Lee
Min Ho
MH
Choi
Ho Soon
HS
Kim
Seok Hyeon
SH
Ahn
Dong Hyun
DH
D000328:Adult; D002908:Chronic Disease; D003071:Cognition; D004569:Electroencephalography; D005260:Female; D006501:Hepatic Encephalopathy / Q000175:diagnosis* / Q000209:etiology; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests