WJNS  Vol.3 No.4 , November 2013
Visual electrophysiological examination in diagnosis of hepatic encephalopathy

Clinical observation of the neuropsychiatric condition, psychometric tests, and EEG recordings has been used to diagnose hepatic encephalopathy. However, no standardization for the diagnosis of minimal hepatic encephalopathy (MHE) has been achieved. According to the study in normal subjects, visual electrophysiology testing is a method of simple, objective record for the medical examination, which includes visual evoked potentials (VEP), electroretinograms (ERG), etc. 23 hepatic encephalopathy patients prospectively underwent visual electrophysiology testing and laboratory serum analysis, and it was found that 22 visual electrophysiology abnormalities which showed that the amplitudes were decreased and the implicit times were prolonged compared with the normal. The relationship between biochemical parameters and visual electrophysiology parameters showed that visual recording was related to the damage of the liver. On the basis of this preliminary study, we could conclude that this method can be as a way to predict for hepatic encephalopathy and it appears to be a method in the recognition of the MHE.


Cite this paper
Zhang, L. , Li, L. , Zhou, X. , Xia, F. and Zhang, Z. (2013) Visual electrophysiological examination in diagnosis of hepatic encephalopathy. World Journal of Neuroscience, 3, 204-208. doi: 10.4236/wjns.2013.34026.
[1]   Zhan, T. and Stremmel, W. (2012) The diagnosis and treatment of minimal hepatic encephalopathy. Deutsches Arzteblatt International, 109, 180-187.

[2]   Zamora, N.L. and Torre, D.A. (2011) Minimal hepatic encephalopathy. Annals of Hepatology, 10, S50-S54.

[3]   Kuhrt, H., et al. (2004) Rabbit retinal organ culture as an in-vitro model of hepatic retinopathy. Graefe’s Archive for Clinical and Experimental Ophthalmology, 242, 512-522. http://dx.doi.org/10.1007/s00417-004-0882-2

[4]   Reichenbach, A., et al. (1995) Hepatic retinopathy: Morphological features of retinal glial (Muller) cells accompanying hepatic failure. Acta Neuropathologica, 90, 273-281. http://dx.doi.org/10.1007/BF00296511

[5]   Uhlmann, S., Uhlmann, D., Hauss, J., Reichenbach, A., Wiedemann, P. and Faude, F. (2003) Recovery from hepatic retinopathy after liver transplantation. Archive for Clinical and Experimental Ophthalmology, 241, 451-457. http://dx.doi.org/10.1007/s00417-003-0639-3

[6]   Scholl, H.P. and Zrenner, E. (2000) Electrophysiology in the investigation of acquired retinal disorders. Survey of Ophthalmology, 45, 29-47. http://dx.doi.org/10.1016/S0039-6257(00)00125-9

[7]   Halliday, A.M., McDonald, W.I. and Mushin, J. (1973) Delayed pattern evoked responses in optic neuritis in relation to visual acuity. Transactions of the Ophthalmological Societies of UK, 93, 315-324.

[8]   Zamir, D., et al. (2002) Early detection of hepatic encephalopathy by recording visual evoked potential (VEP). Roczniki Akademii Medycznej w Bialymstoku, 47, 186-193.

[9]   Zhu, Q., Yang, Y.L. and Wang, M.J. (1993) Diagnosis of subclinical hepatic encephalopathy: A parallel and comparative study between the evoked potentials and the performance psychometric tests. Zhonghua Nei Ke Za Zhi, 32, 676-678.

[10]   Michael, F.M., Graham, E.H., Mathias, W.S. and Yamamoto, S. (2004) Standard for clinical electroretinography (2004 update). Documenta Ophthalmologica, 109, 107-114.

[11]   Miao, J.Y., Pan, B.R., Guo, S.Y., et al. (1990) The relationship between VEP and HE in liver cirrhosis. Medical Journal of Chinese PLA, 15, 113-115.