Neuropsychological assessment of hepatic encephalopathy: ISHEN practice guidelines.
Low-grade or minimal hepatic encephalopathy (MHE) is characterised by relatively mild neurocognitive impairments, and occurs in a substantial percentage of patients with liver disease. The presence of MHE is associated with a significant compromise of quality of life, is predictive of the onset of overt hepatic encephalopathy and is associated with a poorer prognosis for outcome. Early identification and treatment of MHE can improve quality of life and may prevent the onset of overt encephalopathy, but to date, there has been little agreement regarding the optimum method for detecting MHE. The International Society on Hepatic Encephalopathy and Nitrogen Metabolism convened a group of experts for the purpose of reviewing available data and making recommendations for a standardised approach for neuropsychological assessment of patients with liver disease who are at risk of MHE. Specific recommendations are presented, along with a proposed methodology for further refining these assessment procedures through prospective research.
Randolph
Christopher
C
Department of Neurology, Loyola University Medical Center, Maywood, IL, USA. crandol@lumc.edu
Hilsabeck
Robin
R
Kato
Ainobu
A
Kharbanda
Parampreet
P
Li
Yu-Yuan
YY
Mapelli
Daniela
D
Ravdin
Lisa D
LD
Romero-Gomez
Manuel
M
Stracciari
Andrea
A
Weissenborn
Karin
K
D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D006501:Hepatic Encephalopathy / Q000150:complications*; D006801:Humans; D009483:Neuropsychological Tests; D012720:Severity of Illness Index