Clinical Features and Brain MRI Findings in Liver Cirrhosis-related Acute Metabolic Encephalopathy.
- Author:
Woo Hyun CHEON
1
;
Sun Young KIM
;
Young Oh KWEON
;
Doo Kyo JUNG
;
Sung Pa PARK
;
Chung Kyu SUH
Author Information
1. Department of Neurology, Kyungpook National University School of Medicine, Daegu, Korea. dkjung@mail.knu.ac.kr
- Publication Type:Original Article
- Keywords:
Liver cirrhosis;
Metabolic encephalopathy;
Hepatocerebral degeneration;
Magnetic resonance imaging
- MeSH:
Alcoholism;
Ammonia;
Ataxia;
Autoimmune Diseases;
Brain Diseases, Metabolic*;
Brain*;
Cerebellar Nuclei;
Cerebellum;
Consciousness;
Corpus Callosum;
Dysarthria;
Dyskinesias;
Extremities;
Hematologic Tests;
Hepatitis;
Hepatolenticular Degeneration;
Humans;
Liver Cirrhosis;
Liver Diseases;
Liver*;
Magnetic Resonance Imaging*;
Neurologic Manifestations;
Reference Values;
Ultrasonography
- From:Journal of the Korean Neurological Association
2005;23(5):621-626
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Chronic liver disease is a common cause of metabolic neurologic deterioration. We analyzed the clinical features and MRI findings of patients with liver cirrhosis who showed rapidly progressing cerebral dysfunction. METHODS: From August 2001 to July 2003, we had 9 liver cirrhosis patients hospitalized due to acutely developed and rapidly progressed neurologic symptoms that were caused not by other metabolic disturbances. Blood tests and liver ultrasonography were performed to assess the severity of liver cirrhosis. A brain MRI study was done in all patients. RESULTS: The causes of liver cirrhosis were viral hepatitis (n=6), chronic alcoholism (n=2), and autoimmune disease (n=1). Serum ammonia and electrolyte levels were within the normal range. Truncal or limbs ataxia and dysarthria were the most common symptoms. The corpus callosum and dentate nucleus of the cerebellum were commonly involved on diffusion- and T2-weighted MRI. In spite of intensive investigation and treatment, all patients had a rapidly deteriorating course with the appearance of uncontrolled abnormal movements and a decreased consciousness level. Their deaths occured within 1 month of the onset of symptoms. CONCLUSIONS: We present nine liver cirrhosis patients with characteristic clinical features and diffusion- and T2-weighted MRI findings for the first time. It is assumed that some neurologic circuit plays a role in pathogenesis.
