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Pol. Merkur. Lek (Pol. Med. J.), 2016, XL/236: 117-121 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2016, XL/236: 117-121

Title: Clinical importance and diagnostic methods of minimal hepatic encephalopathy

Authors: Stawicka A, Zbrzeźniak J, Świderska A, Kilisińska N, Świderska M, Jaroszewicz J, Flisiak R. 

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN POLISH.

Clinical importance and diagnostic methods of minimal hepatic encephalopathy


Stawicka A, Zbrzeźniak J, Świderska A, Kilisińska N, Świderska M, Jaroszewicz J, Flisiak R.

Department of Infectious Diseases and Hepatology, Medical University of Białystok, Poland

Minimal hepatic encephalopathy (MHE) encompasses a number of neuropsychological and neurophysiological disorders in patients suffering from liver cirrhosis, who do not display abnormalities during a medical interview or physical examination. A negative influence of MHE on the quality of life of patients suffering from liver cirrhosis was confirmed, which include retardation of ability of operating motor vehicles and disruption of multiple health-related areas, as well as functioning in the society. The data on frequency of traffic offences and accidents amongst patients diagnosed with MHE in comparison to patients diagnosed with liver cirrhosis without MHE, as well as healthy persons is alarming. Those patients are unaware of their disorder and retardation of their ability to operate vehicles, therefore it is of utmost importance to define this group. The term minimal hepatic encephalopathy (formerly „subclinical” encephalopathy) erroneously suggested the unnecessity of diagnostic and therapeutic procedures in patients with liver cirrhosis. Diagnosing MHE is an important predictive factor for occurrence of overt encephalopathy – more than 50% of patients with this diagnosis develop overt encephalopathy during a period of 30 months after. Early diagnosing MHE gives a chance to implement proper treatment which can be a prevention of overt encephalopathy. Due to continuing lack of clinical research there exist no commonly agreed-upon standards for definition, diagnostics, classification and treatment of hepatic encephalopathy. This article introduces the newest findings regarding the importance of MHE, scientific recommendations and provides detailed descriptions of the most valuable diagnostic methods.

Key words: minimal hepatic encephalopathy, liver cirrhosis, psychometric tests, PHES

Pol Med J, 2016; XL (236); 117–121