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Related Experiment Videos

Hepatic encephalopathy mimicking stroke. A case report.

J W Atchison1, M Pellegrino, P Herbers

  • 1Department of Rehabilitation Medicine, University of Kentucky College of Medicine, Lexington 40504.

American Journal of Physical Medicine & Rehabilitation
|April 1, 1992
PubMed
Summary

Hepatic encephalopathy can cause stroke-like symptoms, such as unilateral weakness, a previously undescribed neurological deficit. Prompt treatment of liver dysfunction and rehabilitation resolved these symptoms, highlighting the importance of assessing liver function in stroke mimics.

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Area of Science:

  • Neurology
  • Hepatology
  • Internal Medicine

Background:

  • Hepatic encephalopathy (HE) is a neuropsychiatric complication of liver dysfunction.
  • Neurological deficits mimicking cerebrovascular accidents (CVAs) are rare presentations of HE.
  • Unilateral weakness as a manifestation of HE has not been previously reported in English literature.

Observation:

  • A 46-year-old woman presented with left hemiparesis and cognitive impairment following general anesthesia.
  • Initial assessment suggested a right CVA, but neurological examination revealed inconsistencies.
  • The patient exhibited signs of significant liver failure and a flapping tremor.

Findings:

  • The patient's neurological deficits, including left-sided weakness and tremor, resolved with intensive inpatient rehabilitation and treatment of hepatic dysfunction.

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  • This case highlights a novel presentation of hepatic encephalopathy.
  • Recovery was significant, leading to independence in ambulation and daily living activities.

    • Implications:

    • Clinicians should consider hepatic encephalopathy in the differential diagnosis of stroke mimics, especially in patients with known or suspected liver disease.
    • A comprehensive history, physical examination, and liver function assessment are crucial for patients presenting with unusual neurological deficits and recovery patterns.
    • This finding expands the spectrum of neurological manifestations associated with liver failure.