Diagnosis of minimal hepatic encephalopathy

Abstract

Minimal hepatic encephalopathy (mHE) has significant impact upon a liver patient's daily living and health related quality of life. Therefore a majority of clinicians agree that mHE should be diagnosed and treated. The optimal means for diagnosing mHE, however, is controversial. This paper describes the currently most frequently used methods-EEG, critical flicker frequency, Continuous Reaction time Test, Inhibitory Control Test, computerized test batteries such as the Cognitive Drug Research test battery, the psychometric hepatic encephalopathy score (PHES) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)-and their pros and cons.

Keywords: CDR, cognitive drug research; CFF, critical flicker frequency; CRT, continuous reaction time test; EEG, electroencephalography; ICT, inhibitory control test; PHES, psychometric hepatic encephalopathy score; PSE, portosystemic encephalopathy; RBANS, repeatable battery for the assessment of neuropsychological status; TA, target accuracy; WL, weighted lures; diagnostic means; diagnostic use; mHE, minimal hepatic encephalopathy; minimal hepatic encephalopathy; sensitivity; specificity.