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NEUROLOGIC COMPLICATIONS OF LIVER DISEASE

NEUROLOGIC COMPLICATIONS OF LIVER DISEASE. Dr. ANAS JOUHAR. NEUROLOGIC COMPLICATIONS can be observed in patients with either acute or chronic liver Range from vogues symptoms ( fatigue ) to sever (coma ). Clinical features of hepatic Encephalopathy ( Cirrhosis ).

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NEUROLOGIC COMPLICATIONS OF LIVER DISEASE

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  1. NEUROLOGICCOMPLICATIONS OF LIVER DISEASE Dr. ANAS JOUHAR

  2. NEUROLOGIC COMPLICATIONS can be observed in patients with either acute or chronic liver • Range from vogues symptoms ( fatigue ) to sever (coma )

  3. Clinical features of hepatic Encephalopathy ( Cirrhosis ) • Most characteristic symptoms extrapyramidal symptoms • Neurological examination may disclose some hepatic failure before it disclose clinically.

  4. Clinical course of HE • Minimal HE : Slight attention deficits • HE I : Psychomotor slowing • HE II : Disorientation, bizarre, lethargy • HE III : Somnolence – stupor • HE IV : Coma

  5. Other clinical feature of HE • Rapid progress spastic paraplegia (hepatic mylopathy ) • Progress parkinsonian syndromes (hepatolenticular degeneration ) • Both of them due to portosystemic shunt

  6. Acute Liver Failure • Symptoms progress very fast • Brain edema and seizure common in ALF • Seizure seen in 45% of ALF • Seizure due to plasma amonia levels > 120 mico mol/L

  7. PATHOPHYSIOLOGY • Ammonia has been considered as main toxin to development of HE • Recent hypotheses focus on ammonia induced astrocyte swelling

  8. THERAPY • Aimed at the reduction of ammonia production and absorption in gut • Nonabsorbable disaccharides and antibiotics • Ornithineaspartate is used to support ammonia metabolism in muscle

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