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Evoked potentials in liver diseases

N S Chu1, S S Yang, Y F Liaw

  • 1Department of Neurology, Chang Gung Memorial Hospital, Taipei, Taiwan.

Journal of Gastroenterology and Hepatology
|January 4, 1998
PubMed
Summary
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Evoked potentials objectively assess nervous system function in liver disease. Somatosensory evoked potentials (SEP) show promise for early detection and monitoring of hepatic encephalopathy (HE).

Area of Science:

  • Neuroscience
  • Hepatology
  • Clinical Electrophysiology

Background:

  • Evoked potentials (EPs) provide objective, quantitative assessment of peripheral and central nervous system (PNS/CNS) function.
  • Liver diseases, including hepatic encephalopathy (HE), viral hepatitis B, alcoholic liver disease, and Wilson's disease (WD), can impact neurological function.

Purpose of the Study:

  • To investigate the utility of somatosensory (SEP), brainstem auditory (BAEP), and visual evoked potentials (VEP) in evaluating CNS and PNS function in various liver diseases.
  • To assess the role of EPs in the diagnosis and monitoring of hepatic encephalopathy (HE).

Main Methods:

  • Utilized SEP, BAEP, and VEP over eight years in patients with viral hepatitis B, alcoholic liver disease, WD, and HE.
  • Analyzed specific components and latencies of evoked potentials to assess central and peripheral nerve conduction.

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Main Results:

  • In HE, cortical SEP components show sequential prolongation and disappearance, suggesting primary cerebral cortical dysfunction; BAEP remains unchanged.
  • SEP abnormalities correlate with HE severity and prognosis; absence of N20-P25 component in fulminant hepatic failure indicates high mortality.
  • Central conduction time of BAEP is prolonged in WD, alcoholic liver disease, and hepatitis B cirrhosis, with severity ranking WD > alcoholic liver disease > hepatitis B.
  • Peripheral nerve conduction (N9 latency of SEP) is slowed in alcoholic liver disease and hepatitis B cirrhosis, but normal in WD.

Conclusions:

  • Evoked potentials are valuable tools for evaluating CNS and PNS function across a spectrum of liver diseases.
  • Median nerve SEP demonstrates potential for early HE detection and clinical course monitoring.
  • EPs aid in differentiating neurological involvement severity in WD, alcoholic liver disease, and hepatitis B.