Korean J Hepatol > Volume 11(4); 2005 > Article
The Korean Journal of Hepatology 2005;11(4): 329-338.
The Role of Neuropsychological Testing and Electroencephalogram for Early Detection of Minimal Hepatic Encephalopathy
Choon Shik Choi, M.D., Byung Ik Kim, M.D.1, Min Ho Lee, M.D., Ho Soon Choi, M.D., Seok Hyeon Kim, M.D.2 and Dong Hyun Ahn, M.D.2
Department of Internal Medicine, Department of Psychology1, Hanyang University Medical College, Department of Internal Medicine2, Sungkyunkwan University, Kangbuk Samsung Hospital, Seoul, Korea
Minimal hepatic encephalopthy in patients with clinically asymptomatic chronic progressive liver disease may have adverse effects on daily activity. We evaluated the differences in the cognitive function of patients with chronic hepatitis and liver cirrhosis group according to the Child-Pugh classification. Methods: We enrolled 61 consecutive chronic liver disease patients. We used the following study instruments: visual continuous performance test, a spatial memory test, the Wisconsin card-sorting test chosen from Neuroscan and STIM system (Study of the Usefulness of Computerized Neuropsychological Test, Neurosoft company, New York, NY, USA), a global-local processing test and an electroencephalogram (EEG). Results: A significant correlation was found between neurologic abnormalities and the degree of liver disease. The result of the neuropsychological test and the EEG showed that cognitive function decreased according to the severity of chronic liver disease, especially in liver cirrhosis. Cirrhotic patients, especially in Child-Pugh C group, exhibited selective deficits in complex attention and fine motor skills as well as visual spatial perception, with preservation of memory. Conclusions: The STIM and EEG are simple, subjective and reproducible methods and may be used as early detection methods of minimal hepatic encephalopthy. (Korean J Hepatol 2005;11:329-338)
KeyWords: Minimal hepatic encephalopathy, Liver cirrhosis, Neuropsychological test, Electroencephalogram
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