Published online Dec 28, 2018. doi: 10.3748/wjg.v24.i48.5446
Peer-review started: October 5, 2018
First decision: November 1, 2018
Revised: November 8, 2018
Accepted: November 9, 2018
Article in press: November 9, 2018
Published online: December 28, 2018
Processing time: 85 Days and 1.6 Hours
Minimal hepatic encephalopathy (MHE) represents the mildest type of hepatic encephalopathy (HE). This condition alters the performance of psychometric tests by impairing attention, working memory, psychomotor speed, and visuospatial ability, as well as electrophysiological and other functional brain measures. MHE is a frequent complication of liver disease, affecting up to 80% of tested patients, depending of the diagnostic tools used for the diagnosis. MHE is related to falls, to an impairment in fitness to drive and the development of overt HE, MHE severely affects the lives of patients and caregivers by altering their quality of life (QoL) and their socioeconomic status. MHE is detected in clinically asymptomatic patients through appropriate psychometric tests and neurophysiological methods which highlight neuropsychological alterations such as video-spatial orientation deficits, attention disorders, memory, reaction times, electroencephalogram slowing, prolongation of latency evoked cognitive potentials and reduction in the critical flicker frequency. Several treatments have been proposed for MHE treatment such as non-absorbable disaccharides, poorly absorbable antibiotics such rifaximin, probiotics and branched chain amino acids. However, because of the multiple diagnosis methods, the various endpoints of treatment trials and the variety of agents used in trials, to date the treatment of MHE is not routinely recommended apart from on a case-by-case basis. Aim of this review is analyze the burden of MHE on QoL of patients and provide a brief summary of therapeutic approaches.
Core tip: Minimal hepatic encephalopathy (MHE) being related to falls, an impairment in fitness to drive and the development of overt hepatic encephalopathy (HE), severely affects the lives of patients and caregivers by altering their quality of life (QoL) and their socioeconomic status. The aim of this review is to analyze the burden of MHE on QoL of patients and provide a brief summary of therapeutic approaches.