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Case Reports
. 2015 Jul;20(3):277-9.
doi: 10.17712/nsj.2015.3.20140759.

Hepatic encephalopathy coexists with acquired chronic hepatocerebral degeneration

Feng-Zhen Huang  1 , Xuan Hou, Tie-Qiao Zhou, Si Chen
Affiliations
Case Reports

Hepatic encephalopathy coexists with acquired chronic hepatocerebral degeneration

Feng-Zhen Huang et al. Neurosciences (Riyadh). 2015 Jul.

Abstract

Hyperkinetic extrapyramidal syndrome is the typical clinical characteristic of acquired hepatocerebral degeneration (AHD), but is usually not observed with hepatic encephalopathy (HE). We present a case of AHD coexisting with HE. Both conditions were secondary to liver cirrhosis and hepatitis C virus infection. The brain MRI showed bilateral and symmetric high T1 signal-intensity in the globus pallidus, and diffuse high signal-intensity of the hemispheric white matter on T2-FLAIR images. As we usually neglect the existence of AHD, the diagnosis is often ignored, especially when it coexists with HE. This case highlights the need to distinguish irreversible AHD from HE.

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Figures

Figure 1
Figure 1
Brain MRI acquired at 3.0T. A) T1-weigthed images show bilateral and symmetric high-intensity of the globus pallidus, which reflects abnormal manganese deposition related to acquired hepatocerebral degeneration. B & C) Diffuse high-intensity in subcortical hemispheric white matter was observed on T2-weighted images. (D & E) The lesions were mildly hyperintense on DWI and unequivocal hyperintense on the ADC map likely reflecting interstitial edema secondary to hyperammonemia.
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References

    1. Sturgeon JP, Shawcross DL. Recent insights into the pathogenesis of hepatic encephalopathy and treatments. Expert Rev Gastroenterol Hepatol. 2014;8:83–100. - PubMed
    1. Dhiman RK, Kurmi R, Thumburu KK, Venkataramarao SH, Agarwal R, Duseja A, et al. Diagnosis and prognostic significance of minimal hepatic encephalopathy in patients with cirrhosis of liver. Dig Dis Sci. 2010;55:2381–2390. - PubMed
    1. Maffeo E, Montuschi A, Stura G, Giordana MT. Chronic acquired hepatocerebral degeneration, pallidal T1 MRI hyperintensity and manganese in a series of cirrhotic patients. Neurol Sci. 2014;35:523–530. - PubMed
    1. Stracciari A, Baldin E, Cretella L, Delaj L, D’Alessandro R, Guarino M. Chronic acquired hepatocerebral degeneration: effects of liver transplantation on neurological manifestations. Neurol Sci. 2011;32:411–415. - PubMed
    1. Ishihara T, Ito M, Watanabe H, Ishigami M, Kiuchi T, Sobue G. [Case of acquired hepatocerebral degeneration with prominent improvement of parkinsonism and cognitive deficits after living-donor liver transplantation] Rinsho Shinkeigaku. 2012;52:581–584. Japanese. - PubMed

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