[Biosynthesis of insulin. The Ferdinand-Bertram-Award lecture (author's transl)]

EEG recordings were done 1-3 months before and up to 5 years after shunt operations in 20 men and 7 women (aged 16 to 69 years) with liver cirrhosis, most of them of alcoholic aetiology, and with oesophageal bleeding. The EEG diagnosed encephalopathies before there were any clinical suspicions. Pre-operatively half of the patients (14) had EEG changes indicating encephalopathy. In only four patients who before operation had a normal EEG were there post-operative EEG changes indicating encephalopathy. In the other nine patients the EEG was normal before and after shunt operation. The abnormal EEGs which occurred post-operatively or got worse generally returned to pre-operative levels within 3-4 weeks. These studies indicate that in patients with pre-operative encephalopathy there is no improvement in the EEG after shunt operation. On the other hand, if pre-operatively there are no significant cerebral abnormalities, post-operative changes of encephalopathy are rare (14.8%).