Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 21, 2006; 12(11): 1793-1794
Published online Mar 21, 2006. doi: 10.3748/wjg.v12.i11.1793
Hepatic encephalopathy with status epileptics: A case report
Hiroto Tanaka, Hiroki Ueda, Yohei Kida, Hiroko Hamagami, Tomikimi Tsuji, Masakazu Ichinose
Hiroto Tanaka, Hiroki Ueda, Yohei Kida, Hiroko Hamagami, Masakazu Ichinose, The Third Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, 641-0015, Japan
Tomikimi Tsuji, the Department of Neuropsychology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, 641-0015, Japan
Correspondence to: Masakazu Ichinose, MD, PhD, Third Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, 641-0015, Japan. hgvttv1@r5.dion.ne.jp
Telephone: +81-73-4410619 Fax: +81-73-4462877
Received: October 18, 2005
Revised: October 30, 2005
Accepted: December 7, 2005
Published online: March 21, 2006
Abstract

A 62-year-old male with decompensated liver cirrhosis due to hepatitis C virus developed severe hepatic encephalopathy with status epileptic us. The blood ammonia level on admission was more than twice the normal level. Brain computed tomography and magnetic resonance imaging were normal. In addition, electroencephalogram showed diffuse sharp waves, consistent with hepatic encephalopathy. The status epilepticus was resolved after antiepileptic therapy (phenytoin sodium) and treatment for hepatic encephalopathy (Branched chain amino acids). The blood ammonia level normalized with the clinical improvement and the patient did not have a recurrence of status epilepticus after the end of the antiepileptic treatment. Additionally, the electroencephalogram showed normal findings. Thus, we diagnosed the patient as hepatic encephalopathy with status epilepticus. We consider the status epilepticus of this patient to a rare and interesting finding in hepatic encephalopathy.

Keywords: Status epilepticus, Hepatic encephalopathy, Decompensated liver cirrhosis, Electroencephalogram