Diagnosing Minimal Hepatic Encephalopathy

Launched by ESBJERG HOSPITAL - UNIVERSITY HOSPITAL OF SOUTHERN DENMARK · Jun 22, 2022

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Eligibility criteria

• Inclusion criteria for patients with liver cirrhosis:
• • 1. Age\> 18
• • 2. Liver cirrhosis verified by biopsy or appropriate clinic and biochemistry as well as imaging.
• • 3. Written informed consent
• • 4. Speaks and understands Danish
• For the subgroup with liver cirrhosis and normal cognition:
• • 1. Normal result in PSE and CRT testing and clinical examination without evidence of HE
• For the subgroup with liver cirrhosis and minimal hepatic encephalopathy:
• • 2. Abnormal result in PSE and / or CRT test, but oriented in time, place and own data.
• For the subgroup with liver cirrhosis and HE grade 2, the following applies:
• • 3. Abnormal PSE and CRT result and / or disoriented in time, place or own data and / or asterixis or other clinical symptoms of HE
• • 4. Ability to collaborate on the performance of CRT test, PSE test and EEG
• Inclusion criteria healthy:
• • 1. Liver healthy
• • 2. Age over 18 years
• • 3. Formal education ≤ 14 years
• • 4. Written informed consent
• • 5. Speaks and understands Danish
• Inclusion criteria for pre-cirrhosis liver disease:
• As for healthy controls plus:
• • 1. In our local outpatient clinic
• • 2. Proven pre-cirrhosis liver disease
• Exclusion Criteria:
• • 1. Organic brain disease (eg previous epilepsy, apoplexy, dementia)
• • 2. Hyponatraemia (Na \<124 mmol / L)
• • 3. Sepsis one week prior to tests.
• • 4. Heart failure (EC less than 30% or NYHA class III and IV)
• • 5. Severe chronic obstructive pulmonary disease (GOLD stage 3 and 4 ie FEV1 / FVC below 0.7 and FEV1 \<50% of expected value)
• • 6. Highly controllable diabetes (HbA1C\> 60 mmol / mol)
• • 7. Renal failure (eGFR below 60)
• • 8. Known neurological diseases (epilepsy, stroke, dementia)
• • 9. Intake of coffee or alcohol 6 hours before tests and change of dose in psychoactive drugs within 6 days of the test (morphine, antipsychotics, antidepressants) -