Extractions: Journal of Neurological Sciences (Turkish) Table of Contents NOROL BIL D 18: 2 , 2001 http://www.med.ege.edu.tr/norolbil/2001/NBD16601.html Case Report NEUROIMAGING ASPECTS OF CHRONIC ACQUIRED HEPATOCEREBRAL DEGENERATION IN A CASE REPORT Melda BOZLUOLCAY , Zerrin PELIN , Hayrünissa DENKTAS Istanbul University Cerrahpasa School of Medicine, Department of Neurology, Istanbul , Turkey ABSTRACT Key-words: Chronic acquired hepatocerebral degeneration, magnetic resonance imaging, globus pallidus INTRODUCTION Research using both structural and functional neuroimaging techniques has been under way in an effort to find early markers of brain damage in patients with subclinical hepatic encephalopathy. Structural neuroimaging abnormalities, such as an increased T1-weighted MRI signal intensity in the globus pallidus has been described in cirrhotic patients without overt encephalopathy (4,5,6). These lesions have also been reported in the putamen as well as the mesencephalon in addition to the globus pallidus (7). Also the cerebral cortical and cerebellar atrophy are visualized abnormalities on the MR imaging (8). More recent advances in neuroimaging technology are beginning to reveal unique features in brain of patients with chronic liver failure. However there were very few studies reporting functional neuroimaging (i.e., PET or SPECT) findings (9,10) that may help to understand the nature of lesions in chronic liver disease. In this report, we will discuss the various clinical and radiological features including MR imaging PET and SPECT scan of the CAHD. A case that demonstrated the cognitive impairment and myoclonus was presented.
Final Diagnosis -- Case 221 Acquired hepatocerebral degeneration MR and pathologic findings. Exp Neurol 8 318346;Martinez A (1968) Electron microscopy in human hepatic encephalopathy. http://path.upmc.edu/cases/case221/dx.html
Extractions: FINAL DIAGNOSIS: Acquired (Non-Wilsonian) hepatocerebral degeneration with "shunt myelopathy" DISCUSSION: It is well known that patients with severe liver disease may suffer from a reversible neurologic condition known as hepatic encephalopathy [1,6]. Some of these patients suffer from a more permanent neurologic disorder, particularly if they have surgically induced or spontaneous porto-systemic shunts and experience episodes of severe hepatic encephalopathy with coma. Victor, Adams, et al. reported the features of AHCD in detail in a series of 27 cases [14]. These symptoms and signs included progressive dementia, dysarthria, involuntary movements (including tremor, asterixis, and choreoathetosis), ataxia of limb and gait, and mild pyramidal tract signs, typically in a patient with severe hepatic disease and recurrent episodes of coma. Less commonly reported is a progressive spastic myelopathy in association with AHCD [4,12]. Only about 15 cases have been reported in the world literature with detailed pathological descriptions [2,3,7,9,13]. The present case report has several distinctive features. Whereas most reported cases resulted from a surgically created porto-systemic shunt as a treatment for cirrhosis, a few other cases, including this one, are thought to result from spontaneously created shunts (e.g., varices) with the same functional consequences. The published cases usually had Alzheimer II cells in the brain, but only a few had the severe spongy degeneration in the deep cortex illustrated here. Recently, hepatocerebral degeneration has occasionally been documented in vivo by MRI [8,9]. Few electron microscopic studies of human Alzheimer II cells and hepatocerebral degeneration have been published [5,11]. The present report suggests that the vacuolation results from the disruption of astrocytes.
AJNR -- Flemming Et Al. 23 (8): 1421 MR imaging in patients with chronic hepatic encephalopathy shows symmetric This patterneven anticipates hepatocerebral disease, increases after portosystemic http://www.ajnr.org/cgi/content/full/23/8/1421
Entrez PubMed MRI and MRS examine different aspects of hepatocerebral disease. Publication TypesReview; Review, Tutorial. MeSH Terms Hepatic encephalopathy/metabolism; http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1
Entrez PubMed Ethanol neurotoxicity, Wernicke s encephalopathy, hepatocerebral degeneration, headtrauma, central pontine myelinolysis, MarchiafavaBignami syndrome, pellagra http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstra
Clinical Geriatrics Psychosis in dementia may occur in alcoholic dementia, or dementia associated withhepatic encephalopathy (chronic hepatocerebral degeneration) and Marchiafava http://www.mmhc.com/engine.pl?station=mmhc&template=cgfull.html&id=1984
Extractions: George Eversman, MD Alcohol . Few drugs wreak so much havoc so often and with such predictability. And to complicate matters, alcoholic patients are frequently uncooperative, have more than one underlying disease, and a compliance profile that is usually less than optimal. Critical diagnostic findings may be obscured by ethanol intoxication, and disposition decisions are complicated by the patients compromised capacity for vigilant self-care and appropriate follow-up. Add to these pitfalls the fact that chronic alcoholics tend to be poor historians and that the range of medical and surgical disorders afflicting them can fill a textbook of medicine, and it is clear why these patients are prone to falling between the diagnostic cracks. Although alcoholic patients are frequent users of emergency care, physician recognition of various alcohol-related diseases is poor. Some alcohol-related conditions require immediate lifesaving interventions, whereas others require hospital admission or outpatient referral for resolution. Whatever the diagnosis and ultimate disposition, recognition of chronic alcohol abuse as a cause for these problems is imperative so that early care can be instituted.
Hepatic Encephalopathy - 12 Articles - Part A In conclusion, MRI and MRS examine different aspects of hepatocerebral disease. 2S424.Related Articles, Links Minimal hepatic encephalopathy natural history http://archive.mail-list.com/hbv_research/msg06474.html
Extractions: hbv_research archives mailto:HBV_Research-on@mail-list.com To unsubscribe, send a blank message to mailto:HBV_Research-off@mail-list.com To change your email address, send a message to mailto:HBV_Research-change@mail-list.com with your old address in the Subject: line Web Archive of all messages is at: http://archive.mail-list.com/hbv_research/ Prev by Date: Modulation of hepatitis B virus secretion by naturally occurring mutations in the S gene Next by Date: Hepatic Encephalopathy - 12 articles - Part B Return to Table of Contents:
Extractions: (LaPlante, 1989) Tuberculosis Yes AIDS Yes Severe neurosyphilis Yes Mental retardation Yes Chronic pulmonary coccidioidomycosis Yes Sarcoidosis Yes Post-polio syndrome Yes Malignant neoplasm of thymus Yes Malignant neoplasm of mediastinum Yes Malignant neoplasm of breast Malignant neoplasm of uterus, part unspecified
Handbook Of Medical Psychiatry, 2nd Edition 257.Hypocalcemia 258.Uremic encephalopathy 259.Dialysis Disequilibrium Syndrome 260.Hepaticencephalopathy and Acquired hepatocerebral Degeneration 261.Hepatic http://www.harcourt-international.com/catalogue/title.cfm?ISBN=0323029116
The Turkish Journal Of Gastroenterology some authors reported that the MRI findings of acquired hepatocerebral degenerationare Subclinical hepatic encephalopathy (SHE) has been reported in up to 84 http://www.turkgastro.org/text.php?id=4
Hepatonet Translate this page Improvement in chronic hepatocerebral degeneration following liver transplantation. Reversalof hepatic encephalopathy after occlusion of total portasystemic http://www.hepatonet.com/formacion/expertos3.php
Extractions: E-mail: jcordoba@hg.vhebron.es Subir Subir Subir Subir Dieta Subir Subir Subir Subir 1. Cordoba J, Blei AT. Treatment of hepatic encephalopathy. Am J Gastroenterol 1997; 92: 1429-39. 2. McMcrea M, Cordoba J, Vessey G, Blei AT, Randolph C. Neuropsychological characterization and detection of subclinical hepatic encephalopathy. Arch Neurol 1996; 53: 758-63. 3. Adams RD, Foley JM. The neurological disorder associated with liver disease. Proc Ass Res Nerv Dis 1953; 32: 198-237.
Scope Of Work portalsystemic encephalopathy) Uremic encephalopathy encephalopathy associatedwith Chronic acquired (Non-Wilsonian) hepatocerebral degeneration Kernicterus http://www.cochraneneuronet.org/livello2/scope_of_work2.html
E. Management OF COMPLICATIONS OF CHRONIC LIVER DISEASE Patients with chronic encephalopathy should be advised against driving and E, PenderM, Chalk J. Improvement in chronic hepatocerebral degeneration following http://www.nzliver.org/Protocol/Finished/E Mgmt of Complications LTU Protocol.ht
Extractions: All patients should be undergo oesophago-gastro-duodenoscopy (OGD) as per GI Bleeding Guidelines. In patients in whom variceal bleeding is suspected empirical treatment with Octreotide (see below) is recommended prior to diagnostic OGD. Management of suspected bleeding oesophageal varices: URGENT SCLEROTHERAPY/BANDING continued massive haematemesis encephalopathy suspected aspiration Proceed with oesophago-gastro-duodenoscopy (OGD) and carry out variceal band ligation/sclerotherapy If bleeding not controlled SSB tube (by experienced physician only) Increase PEEP Consider TIPPS If bleeding controlled repeat OGD in 24 hrs: IF uncertain that bleeding has been arrested.
ICP Monitors Related to Alcohol Induced Hepatic Disease. 1. Hepatic encephalopathy (hepatic coma). Notedto have elevated blood ammonia levels. 2. hepatocerebral Degeneration. http://www.ucch.org/sections/neurosurg/NeuroReview/10.2-Neurology/AlcoholCNS-PNS
Extractions: Ethanol and its Effects on the Nervous System I. Intoxication Clinical Features excitement behavioural change slow learning decreased concentration decreased judgement confusion slurred speech incoordination blackouts (palimpsests) loss of airway protective reflexes depressed LOC respiratory depression associated with accidents (MVA), falls (SDH), anoxia, and death. II. Withdrawal State Clinical Features anxiety tremulousness hallucinations withdrawal seizures (rum fits) delirium tremens confusion, delusions, hallucinations, tremor, agitation death in 10% from cardiovasc collapse, hyperthermia, arrhythmia hypoglycemia keto-acidosis III. Nutritional Disorders 1. Wernicke Encephalopathy Clinical Features Nystagmus Conjugate gaze palsies (ophthalmoplegia) Gait ataxia Confusion Pathology 2. Korsakoff's Psychosis 3. Nutritional Polyneuropathy Pathology Axonal degeneration (secondary loss of myelin) Segmental demyelination Changes more severe distally IV. Diseases of Uncertain Etiology 1. Cerebellar Degeneration 2. Cerebral Atrophy 3. Central Pontine Myelinolysis 5. Deficiency Amblyopia (Tobacco-Alcohol)
Dr. Claudia Zwingmann - Curriculum Vitae International Symposium on hepatocerebral DISORDERS pathophysiology of cerebral 11thInternational Symposium on Hepatic encephalopathy and Nitrogen Metabolism http://www.chemie.uni-bremen.de/leibfritz/homepage/czcv.html
Case Studies and relate closely to the pathogenesis of hepatic encephalopathy and protein oftherapeutic tools applied in patients with the hepatocerebral syndrome is http://www.atozofhealth.com/Amino Acids/case_studies.htm
Extractions: A t o Z of Health Dedicated to Making You Healthier A to Z of Health Biographies General Medicine Cancer ... Search Page Case Studies Oral supplementation with branched-chain amino acids improves transthyretin turnover in rats with carbon tetrachloride-induced liver cirrhosis Journal of Nutrition (USA), 1996, 126/5 (1412-1420) An increase in the resting energy expenditure (REE) on indirect calorimetry was observed by rapid intravenous infusion of a branched chain-enriched amino acid solution into cirrhotic patients. The increases resulted in nutrient-induced thermogenesis (NIT). The percentage of energy expenditure (EE) derived from protein decreased significantly with the infusion of the amino acids. The present pilot study demonstrates that branched chain amino acids can be utilized as energy substrates and a protein-sparing effect occurs in patients with liver cirrhosis.
CNSforum and common subset of acquired hepatocerebral degeneration, whose features are permanentand entirely different from acute hepatic encephalopathy episodes. http://www.cnsforum.com/cp/en/CNSforum/literature/abstracts_otm/neurology/may200
Selecciones Veterinarias Virtual - Bibliografía W, Hickey WF, Dobson W E. Early childhood hepatocerebral degeneration misdiagnosed ofAlpers disease (cronic progressive encephalopathy) produces experimental http://www.seleccionesveterinarias.com/Bibliografia.html
Arquivos De Neuro-Psiquiatria - Translate this page M. The acquired (non Wilsonian) type of chronic hepatocerebral degeneration. in livercirrhosis patients with chronic persistent encephalopathy evaluation by http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X1999000200024&l
