Published online Oct 26, 2022. doi: 10.12998/wjcc.v10.i30.11172
Peer-review started: July 6, 2022
First decision: August 4, 2022
Revised: August 24, 2022
Accepted: September 19, 2022
Article in press: September 19, 2022
Published online: October 26, 2022
Processing time: 106 Days and 13.8 Hours
Hepatic myelopathy (HM) is a rare neurological complication of advanced cirrhosis. Prognosis of patients with HM is generally poor without timely liver transplantation or interventional therapy. Self-resolving HM in patients with alcoholic cirrhosis has never been reported.
A 53-year-old man with alcoholic cirrhosis and recurrent overt hepatic encephalopathy for 1 year was admitted for lower extremity weakness, slow movement, and stumbling gait. The patient was diagnosed with HM after excluding other causes of spastic paraparesis. The patient refused liver transplantation. However, the patient kept total abstinence and received a multidisciplinary treatment for complications of decompensated cirrhosis. The symptoms of HM resolved gradually after 2 years of treatment. All complications of alcoholic cirrhosis resolved after 4 years of follow-up.
The case demonstrates that HM can resolve in patients without liver transplan-tation after total abstinence and systemic management of complications.
Core Tip: Hepatic myelopathy (HM) is a rare neurological complication of advanced cirrhosis. Prompt liver transplantation or interventional therapy may reverse the symptoms of HM. Self-resolving HM in patients with alcoholic cirrhosis has never been reported. Our report presents that self-resolving HM in a patient with alcoholic cirrhosis is possible without any liver transplantation and interventional therapy after promptly controlling the etiology and systemic management of complications. This case provides new insight into the self-remission of patients with HM.