title: Covert Hepatic Encephalopathy: Who Should Be Tested and Treated?
abstract: Covert hepatic encephalopathy is a common problem in cirrhosis, affecting up to 80% of patients. It is defined as test-dependent brain dysfunction with clinical consequences in the setting of cirrhosis in patients who are not disoriented. Because it is not apparent clinically, and diagnostic testing has not been standardized, the issue has often been ignored in clinical practice. Yet, the clinical consequences are notable, including impaired quality of life, diminished work productivity, and poor driving skills.
authors.affiliation: Liver Transplantation Program, Northwestern Feinberg School of Medicine, Arkes 19-041, 676 North Saint Clair, Chicago, IL 60611, USA. Electronic address: s-flamm@northwestern.edu.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Flamm
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D004187:Disaccharides / Q000627:therapeutic use; D004569:Electroencephalography; D006501:Hepatic Encephalopathy / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D059906:Neuroimaging; D009483:Neuropsychological Tests; D018579:Patient Selection; D019936:Probiotics / Q000627:therapeutic use; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin
chemical_list: D000890:Anti-Infective Agents; D004187:Disaccharides; D012294:Rifamycins; D000078262:Rifaximin
keywords: Covert hepatic encephalopathy; Critical flicker frequency; Encephalapp stroop test; Inhibitory control test; Minimal hepatic encephalopathy; Probiotics; Psychometric hepatic encephalopathy score; Rifaximin