Document Type
Article
Publication Date
2019
College/Unit
School of Medicine
Department/Program/Center
Medicine
Abstract
Patients with cirrhosis may experience neurologic complications, including hepatic encephalopathy. Hepatic encephalopathy may be classified as covert (mild symptoms (e.g. lack of awareness)) or overt (moderate to severe symptoms (e.g. confusion or coma)), and symptoms may overlap with other neurologic conditions (e.g. epilepsy, stroke). Managing hepatic encephalopathy includes identifying and treating precipitating factors (e.g. dehydration). First-line treatment for patients with overt hepatic encephalopathy is typically lactulose; to reduce the risk of overt hepatic encephalopathy recurrence, lactulose plus the nonsystemic antibiotic rifaximin is recommended. Rifaximin reduced the risk of breakthrough overt hepatic encephalopathy by 58% versus placebo over 6 months (p < 0.001; 91% of patients in each group were on concomitant lactulose). However, neither pharmacologic hepatic encephalopathy treatment nor liver transplantation may completely reverse neurologic impairment in patients with hepatic encephalopathy. Additional neurologic considerations for patients with cirrhosis include preventing falls, as well as managing sleep-related issues, hyponatremia, and cerebral edema. Thus, monitoring neurologic impairment is an important component in the management of patients with cirrhosis.
Digital Commons Citation
Allampati, Sanath K. and Mullen, Kevin D., "Understanding the impact of neurologic complications in patients with cirrhosis" (2019). Faculty & Staff Scholarship. 2404.
https://researchrepository.wvu.edu/faculty_publications/2404
Source Citation
Allampati, S. K., & Mullen, K. D. (2019). Understanding the impact of neurologic complications in patients with cirrhosis. SAGE Open Medicine, 7, 205031211983209. https://doi.org/10.1177/2050312119832090
Comments
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SAGE Open Medicine Volume 7: 1–8 © The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions httpDs:O//dIo: i1.o0r.g1/107.171/2770/520350132121918983322090 journals.sagepub.com/home/smo