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Related Experiment Videos

Hepatic encephalopathy and reversible cortical blindness.

Y Miyata1, S Motomura, Y Tsuji

  • 1Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

The American Journal of Gastroenterology
|July 1, 1988
PubMed
Summary

Recurrent hepatic encephalopathy can cause temporary cortical blindness in patients with liver cirrhosis. This visual disturbance, characterized by vision loss despite normal pupillary reflexes, resolved with encephalopathy treatment.

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Area of Science:

  • Neurology
  • Hepatology
  • Ophthalmology

Background:

  • Hepatic encephalopathy (HE) is a neuropsychiatric complication of liver dysfunction.
  • Cryptogenic liver cirrhosis is a common cause of chronic liver disease.
  • Transient cortical blindness is a rare neurological symptom.

Observation:

  • A patient with liver cirrhosis experienced recurrent HE (grades II-III).
  • Each HE episode began with complete vision loss, conscious state, and normal pupillary light reflexes.
  • Visual evoked potentials showed a prolonged latency and diminished amplitude in the second negative wave.

Findings:

  • The patient's vision and neurological function normalized after HE treatment.
  • The observed transient vision loss was diagnosed as cortical blindness associated with HE.

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  • This suggests the visual cortex can be affected during HE episodes.

    • Implications:

    • Cortical blindness may precede loss of consciousness in some HE cases.
    • Neurological monitoring in liver cirrhosis patients should include visual function assessment.
    • Understanding HE's impact on the visual cortex may improve diagnostic and therapeutic strategies.