Minimal Hepatic Encephalopathy

Rachel Redfield; Nyan Latt; Santiago J Munoz

doi:10.1016/j.cld.2024.01.004

Minimal Hepatic Encephalopathy

Clin Liver Dis. 2024 May;28(2):237-252. doi: 10.1016/j.cld.2024.01.004. Epub 2024 Feb 8.

Authors

Rachel Redfield¹, Nyan Latt², Santiago J Munoz³

Affiliations

¹ Thomas Jefferson Hospital, Division of Gastroenterology, 132 S. 10th Street, Suite 480, Philadelphia, PA 19106, USA.
² Virtua Health System, Center for Liver Disease and Transplant Program, 63 Kresson Road, Suite 101, Cherry Hill, NJ 08034, USA.
³ The Johns Hopkins University School of Medicine and Medical Institutions, Division of Gastroenterology and Hepatology, 600 N. Wolfe Street, Blalock Building, Suite 465, Baltimore, MD 21287, USA. Electronic address: Smunoz2@jhmi.edu.

PMID: 38548436
DOI: 10.1016/j.cld.2024.01.004

Abstract

Minimal hepatic encephalopathy (MHE) is a pervasive frequent complication of cirrhosis of any etiology. The diagnosis of MHE is difficult as the standard neurologic examination is essentially within normal limits. None of the symptoms and signs of overt HE is present in a patient with MHE, such as confusion, disorientation, or asterixis. Progress has been made in diagnostic tools for detection of attention and cognitive deficits at the point of care of MHE. The development of MHE significantly impacts quality of life and activities of daily life in affected patients including driving motor vehicles and machine operation.

Keywords: Ammonia; Attention; Cirrhosis; Cognitive; Confusion; Covert; Encephalopathy; Minimal.

Publication types

Review

MeSH terms

Cognition Disorders*
Cognitive Dysfunction* / diagnosis
Cognitive Dysfunction* / etiology
Hepatic Encephalopathy* / diagnosis
Hepatic Encephalopathy* / etiology
Hepatic Encephalopathy* / therapy
Humans
Liver Cirrhosis / complications
Quality of Life