STUDY OF ELECTROENCEPHALOGRAPHY CHANGES AND NEUROPSYCHIATRIC TESTS IN MINIMAL HEPATIC ENCEPHALOPATHY IN PATIENTS WITH CIRRHOSIS OF LIVER

Abstract

Hepatic Encephalopathy (HE) is the complex and potentially reversible
neuropsychiatric syndrome which is characterized by symptoms like somnolence,
confusion, asterixis, extrapyramidal rigidity, convulsions and coma. It is difficult to
diagnose Minimal Hepatic Encephalopathy (MHE) among the patients with liver
disease because these patients will be clinically normal. Neurophysiological tests
such as various psychometric tests mainly Psychometric Hepatic Encephalopathy
Score (PHES) is used in identifying this entity.
METHODS: We conducted a crosssectional study to analyse the prevalence of MHE
and to assess the utility of neurophysiological tests, uses of PHES in diagnosis and to
study EEG changes among the patients with MHE, involving 70 cases diagnosed
with liver cirrhosis and 70 controls.
RESULTS: The average age of patients in our study population was 49.43±10.2
years with male predominance. We found prevalence of MHE was 38% with male
predominance. Severity of HE increased with increase in Child-Pugh grade but there
was no statistically significant association. Time taken to complete NCT, DCT and
line drawing tests were significantly higher among MHE patients compared to the
normal individuals. Also, 12 (30.76%) of the population with MHE had slow wave
pattern of EEG, followed by theta waves among 7 (17.94%). 3 (7.7%) and one
patient had delta wave pattern and triphasic wave pattern respectively.
CONCLUSION: The prevalence of MHE was 38% in our study with male
predominance. Alcohol abuse was the most common cause of cirrhosis. Severity of
HE increased with increase in Child-Pugh grade. Time taken to complete NCT, DCT
and line drawing tests were significantly higher among MHE patients compared to
the normal individuals. 12 patients (30.76%) in the study population with MHE had
slow wave pattern of EEG followed by theta waves among 7 (17.94%) patients. 3
(7.7%) and one patient had delta wave pattern and triphasic wave pattern
respectively.