Acquired hepatocerebral degeneration and hepatic encephalopathy: correlations and variety of clinical presentations in overt and subclinical liver disease

Arquivos de Neuro-Psiquiatria

Fernando G. Romeiro²  Madileine F. Américo¹  Fábio S. Yamashiro²  Carlos A. Caramori²  Arthur O. Schelp¹  Antonio C. Santos¹  Giovanni F. Silva² 

[1] ,Universidade Estadual Paulista Faculdade de Medicina de Botucatu Departamento de Clínica MédicaBotucatu SP ,Brazil

关键词: athetosis;    chorea;    dyskinesias;    dystonia;    hepatic encephalopathy;    hepatolenticular degeneration;    hyperkinesis;    movement disorders;    atetose;    coréia;    degeneração hepatolenticular;    discinesias;    distonia;    distúrbios do movimento;    encefalopatia hepática;    hipercinesia;   

DOI  :  10.1590/S0004-282X2011000400017

来源: SciELO

【 摘 要 】

Acquired hepatocerebral degeneration (AHD) and hepatolenticular degeneration can have similar clinical presentations, but when a chronic liver disease and atypical motor findings coexist, the distinction between AHD and hepatic encephalopathy (HE) can be even more complicated. We describe three cases of AHD (two having HE) with different neuroimaging findings, distinct hepatic diseases and similar motor presentations, all presenting chronic arterial hypertension and weight loss before the disease manifestations. The diagnosis and physiopathology are commented upon and compared with previous reports. In conclusion, there are many correlations among HE, hepatolenticular degeneration and AHD, but the overlapping of AHD and HE could be more common depending on the clinical knowledge and diagnostic criteria adopted for each condition. Since AHD is not considered a priority that affects the liver transplant list, the prognosis in AHD patients remains poor, and flow interruption in portosystemic shunts must always be taken into account.

【 授权许可】

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