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Journal Reading - Hepatic Ensefalopati
Journal Reading - Hepatic Ensefalopati
BY
MELYANA , DR
RESOURCE PERSON
DR ETRA ADRIADNO SP.PD
Grade IV Coma
Classification
Classification
Episodic HE
Persistent HE
Classification
Classification
Nonprecipitated
Precipitated
According to the existence
of precipitating factors
Differential
DifferentialDiagnosis
Diagnosis
Recommendation
Recommendation
Hepatic encephalopathy should be classified
according to
the
HAPUS
type of underlying disease,
SLIDENYA KRN
severity of manifestations, ADA DI SLIDE 12
time course
precipitating factors
Classification
severity of manifestations of Hepatic
Encephalopat
Time course
y
Precipitating Factor
Diagnosis
Diagnosisand
andTesting
Testing
Testing for MHE and CHE
Minimal hepatic encephalopathy and CHE is defined as the presence of test-
dependent or clinical signs of brain dysfunction in patients with CLD who are
not disoriented or display asterixis.
CHE test
Predict recurrence of
HE before stopping
HE drug
Diagnosis
Diagnosisand
andTesting
Testing
Several MHE and CHE test
Portosystemic encephalopathy (PSE)
syndrome test The PSE-Syndrom-Test is a
battery consisting of five paper-
The Critical Flicker Frequency (CFF) and-pencil tasks, including
test Number Connection Tests A and
The Continuous Reaction Time (CRT) B, a coding test (Digit Symbol
Test) similar to the Digit Symbol
test
subtest of the Wechsler scales,
The Inhibitory Control Test (ICT) the Serial Dotting Test and the
Line Drawing Test
The Stroop test
The SCAN Test
Electroencephalography examination
Diagnosis
Diagnosisand
andTesting
Testing
Several MHE and CHE test
Portosystemic encephalopathy (PSE)
syndrome test
The Critical Flicker Frequency (CFF)
test Computer asissted test,
determines the frequency at
The Continuous Reaction Time (CRT) which a flickering light becomes
test continuous or 'fused'.
The Inhibitory Control Test (ICT)
The Stroop test
The SCAN Test
Electroencephalography examination
Diagnosis
Diagnosisand
andTesting
Testing
Lactulose is recommended
for prevention of recurrent
episodes of HE after the
initial episode
Recommendation
Recommendationfor
forTreatment
Treatment
Rifaximin is an effective add-on therapy to lactulose for prevention of OHE
recurrence (GRADEI, A, 1).
Rifaximin
Routine prophylactic
therapy (lactulose or
rifaximin) is not
recommended for the
prevention of post TIPS HE
Rifaximin
Recommendation
Recommendationfor
forTreatment
Treatment