Hepatic Encephalopathy in Chronic Liver Disease: 2014 Practice Guideline by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases

Journal of Hepatology

Volumn 61, Issue 3, 2014, Pages 642-659

  Vilstrup, Hendrik ^b   Amodio, Piero ^b   Bajaj, Jasmohan ^b   Cordoba, Juan ^b   Ferenci, Peter ^b   Mullen, Kevin D ^b   Weissenborn, Karin ^b   Wong, Philip ^b   Talwalkar, Jayant A ^b   Conjeevaram, Hari S ^b   Porayko, Michael ^b   Merriman, Raphael B ^b   Jansen, Peter L M ^b   Zoulim, Fabien ^b  

^a EASL Office   (Switzerland)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

ALBUMIN; DISACCHARIDE; FLUMAZENIL; LAXATIVE; METRONIDAZOLE; NEOMYCIN; ORNITHINE ASPARTATE; PROBIOTIC AGENT; RIFAXIMIN;

BRAIN DYSFUNCTION; BRAIN FUNCTION; BRAIN SCINTISCANNING; CHRONIC LIVER DISEASE; CLINICAL EVALUATION; CLINICAL EXAMINATION; CLINICAL FEATURE; DIFFERENTIAL DIAGNOSIS; DISEASE CLASSIFICATION; DISEASE COURSE; DISEASE SEVERITY; EPIDEMIOLOGY; HEPATIC ENCEPHALOPATHY; HOSPITAL DISCHARGE; HUMAN; LABORATORY TEST; LIVER DISEASE; LIVER TRANSPLANTATION; MENTAL DETERIORATION; OVERT HEPATIC ENCEPHALOPATHY; PORTOSYSTEMIC ANASTOMOSIS; PRACTICE GUIDELINE; PRIORITY JOURNAL; PROPHYLAXIS; REVIEW; TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT; CHRONIC DISEASE; COMPLICATION; EUROPE; MEDICAL SOCIETY; UNITED STATES;

CHRONIC DISEASE; EUROPE; HEPATIC ENCEPHALOPATHY; HUMANS; LIVER DISEASES; SOCIETIES, MEDICAL; UNITED STATES;

EID: 84906314102     PISSN: 01688278     EISSN: 16000641     Source Type: Journal    
DOI: 10.1016/j.jhep.2014.05.042     Document Type: Article

References (169)

1. G.H. Guyatt, A.D. Oxman, G.E. Vist, R. Kunz, Y. Falck-Ytter, and P. Alono-Coello et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations BMJ 336 2008 924 926
2. M.O. Rakoski, R.J. McCammon, J.D. Piette, T.J. Iwashyna, J.A. Marrero, and A.S. Lok et al. Burden of cirrhosis on older Americans and their families: analysis of the health and retirement study Hepatology 55 2012 184 191
3. S. Sherlock, W.H.J. Summerskill, L.P. White, and E.A. Phear Portal-systemic encephalopathy. Neurological complications of liver disease Lancet 264 1954 453 457
4. J.E. Fazekas, H.E. Ticktin, and J.G. Shea Effects of L-arginine on hepatic encephalopathy Am J Med Sci 234 1957 462 467
5. P.W. Kaplan, and A.O. Rossetti EEG patterns and imaging correlations in encephalopathy: encephalopathy part II J Clin Neurophysiol 28 2011 233 251
6. H.O. Conn Hepatic encephalopathy L. Schiff, E.R. Schiff, Diseases of the liver 7th ed. 1993 Lippincott Philadelphia, PA 1036 1060
7. G. D'Amico, A. Morabito, L. Pagliaro, and E. Marubini Survival and prognostic indicators in compensated and decompensated cirrhosis Dig Dis Sci 31 1986 468 475
8. A. Ding, A. Lee, M. Callender, M. Loughrey, S.P. Quah, and W.W. Dinsmore Hepatic encephalopathy as an unusual late complication of transjugular intrahepatic portosystemic shunt insertion for non-cirrhotic portal hypertension caused by nodular regenerative hyperplasia in an HIV-positive patient on highly active antiretroviral therapy Int J STD AIDS 21 2010 71 72
9. T. Ito, N. Ikeda, A. Watanabe, K. Sue, T. Kakio, and H. Mimura et al. Obliteration of portal systemic shunts as therapy for hepatic encephalopathy in patients with non-cirrhotic portal hypertension Gastroenterol Jpn 27 1992 759 764
10. P. Ferenci, A. Lockwood, K. Mullen, R. Tarter, K. Weissenborn, and A.T. Blei Hepatic encephalopathy - definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998 Hepatology 35 2002 716 721
11. J. Cordoba New assessment of hepatic encephalopathy J Hepatol 54 2011 1030 1040
12. L. Rikkers, P. Jenko, D. Rudman, and D. Freides Subclinical hepatic encephalopathy: detection, prevalence, and relationship to nitrogen metabolism Gastroenterology 75 1978 462 469
13. F. Del Piccolo, D. Sacerdoti, P. Amodio, G. Bombonato, M. Bolognesi, and D. Mapelli et al. Central nervous system alterations in liver cirrhosis: the role of portal-systemic shunt and portal hypoperfusion Metab Brain Dis 17 2002 347 358
14. J.S. Bajaj, C.M. Schubert, D.M. Heuman, J.B. Wade, D.P. Gibson, and A. Topaz et al. Persistence of cognitive impairment after resolution of overt hepatic encephalopathy Gastroenterology 138 2010 2332 2340
15. O. Riggio, L. Ridola, C. Pasquale, S. Nardelli, I. Pentassuglio, and F. Moscucci et al. Evidence of persistent cognitive impairment after resolution of overt hepatic encephalopathy Clin Gastroenterol Hepatol 9 2011 181 183
16. J.B. Saunders, J.R.F. Walters, P. Davies, and A. Paton A 20-year prospective study of cirrhosis BMJ 282 1981 263 266
17. M. Romero-Gomez, F. Boza, and M.S. Garcia-Valdecasas et al. Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy Am J Gastroenterol 96 2001 2718 2723
18. P. Jepsen, P. Ott, P.K. Andersen, H.T. Sørensen, and H. Vilstrup The clinical course of alcoholic liver cirrhosis: a Danish population-based cohort study Hepatology 51 2010 1675 1682
19. M. Coltorti, C. Del Vecchio-Blanco, N. Caporaso, C. Gallo, and L. Castellano Liver cirrhosis in Italy. A multicentre study on presenting modalities and the impact on health care resources. National Project on Liver Cirrhosis Group Ital J Gastroenterol 23 1991 42 48
20. G.V. Papatheodoridis, J. Goulis, G. Leandro, D. Patch, and A.K. Burroughs Transjugular intrahepatic portosystemic shunt compared with endoscopic treatment for prevention of variceal rebleeding: a meta-analysis Hepatology 30 1999 612 622
21. W. Nolte, J. Wiltfang, C. Schindler, H. Münke, K. Unterberg, and U. Zumhasch et al. Portosystemic hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with cirrhosis: clinical, laboratory, psychometric, and electroencephalographic investigations Hepatology 28 1998 1215 1225
22. P. Amodio, F. Del Piccolo, E. Pettenò, D. Mapelli, P. Angeli, and R. Iemmolo et al. Prevalence and prognostic value of quantified electroencephalogram (EEG) alterations in cirrhotic patients J Hepatol 35 2001 37 45
23. M. Groeneweg, W. Moerland, J.C. Quero, P.F. Krabbe, and S.W. Schalm Screening of subclinical hepatic encephalopathy J Hepatol 32 2000 748 753
24. N. Saxena, M. Bhatia, Y.K. Joshi, P.K. Garg, and R.K. Tandon Auditory P300 event-related potentials and number connection test for evaluation of subclinical hepatic encephalopathy in patients with cirrhosis of the liver: a follow-up study J Gastroenterol Hepatol 16 2001 322 327
25. H. Schomerus, and W. Hamster Quality of life in cirrhotics with minimal hepatic encephalopathy Metab Brain Dis 16 2001 37 41
26. P. Sharma, B.C. Sharma, V. Puri, and S.K. Sarin Critical flicker frequency: diagnostic tool for minimal hepatic encephalopathy J Hepatol 47 2007 67 73
27. J.S. Bajaj Management options for minimal hepatic encephalopathy Expert Rev Gastroenterol Hepatol 2 2008 785 790
28. J. Bustamante, A. Rimola, P.J. Ventura, M. Navasa, I. Cirera, and V. Reggiardo et al. Prognostic significance of hepatic encephalopathy in patients with cirrhosis J Hepatol 30 1999 890 895
29. I.J. Hartmann, M. Groeneweg, J.C. Quero, S.J. Beijeman, R.A. de Man, and W.C. Hop et al. The prognostic significance of subclinical hepatic encephalopathy Am J Gastroenterol 95 2000 2029 2034
30. P. Gentilini, G. Laffi, G. La Villa, R.G. Romanelli, G. Buzzelli, and V. Casini-Raggi et al. Long course and prognostic factors of virus-induced cirrhosis of the liver Am J Gastroenterol 92 1997 66 72
31. L. Benvegnoù, M. Gios, S. Boccato, and A. Alberti Natural history of compensated viral cirrhosis: a prospective study on the incidence and hierarchy of major complications Gut 53 2004 744 749
32. H. Watson, P. Jepsen, F. Wong, P. Gines, J. Cordoba, and H. Vilstrup Satavaptan treatment for ascites in patients with cirrhosis: a meta-analysis of effect on hepatic encephalopathy development Metab Brain Dis 28 2013 301 305
33. B.C. Sharma, P. Sharma, A. Agrawal, and S.K. Sarin Secondary prophylaxis of hepatic encephalopathy: an open-label randomized controlled trial of lactulose vs. placebo Gastroenterology 137 2009 885 891 [891.e1]
34. S. Prasad, R.K. Dhiman, A. Duseja, Y.K. Chawla, A. Sharma, and R. Agarwal Lactulose improves cognitive functions and health-related quality of life in patients with cirrhosis who have minimal hepatic encephalopathy Hepatology 45 2007 549 559
35. P. Amodio, A. Pellegrini, E. Ubiali, I. Mathy, F.D. Piccolo, and R. Orsato et al. The EEG assessment of low-grade hepatic encephalopathy: comparison of an artificial neural network-expert system (ANNES) based evaluation with visual EEG readings and EEG spectral analysis Clin Neurophysiol 117 2006 2243 2251
36. T.D. Boyer, and Z.J. Haskal The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension: update 2009 Hepatology 51 2010 306
37. O. Riggio, S. Angeloni, F.M. Salvatori, S.A. De, F. Cerini, and A. Farcomeni et al. Incidence, natural history, and risk factors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene-covered stent grafts Am J Gastroenterol 103 2008 2738 2746
38. M. Bai, X. Qi, Z. Yang, Z. Yin, Y. Nie, and S. Yuan et al. Predictors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in cirrhotic patients: a systematic review J Gastroenterol Hepatol 26 2011 943 951
39. G. Spina, and R. Santambrogio The role of portosystemic shunting in the management of portal hypertension Baillieres Clin Gastroenterol 6 1992 497 515
40. M. Stepanova, A. Mishra, C. Venkatesan, and Z.M. Younossi In-hospital mortality and economic burden associated with hepatic encephalopathy in the United States from 2005 to 2009 Clin Gastroenterol Hepatol 10 2012 1034 1041
41. W.R. Kim, R.S. Brown Jr., N.A. Terrault, and H. El-Serag Burden of liver disease in the United States: summary of a workshop Hepatology 36 2002 227 242
42. K.M. Fleming, G.P. Aithal, M. Solaymani-Dodaran, T.R. Card, and J. West Incidence and prevalence of cirrhosis in the United Kingdom, 1992-2001: a general population-based study J Hepatol 49 2008 732 738
43. N. Gitlin, D.C. Lewis, and L. Hinkley The diagnosis and prevalence of sub-clinical hepatic encephalopathy in apparently healthy, ambulant, non-shunted patients with cirrhosis J Hepatol 3 1986 75 82
44. A.H. Lockwood "What's in a name?" Improving the care of cirrhotics J Hepatol 32 2000 859 861
45. P. Amodio, S. Montagnese, A. Gatta, and M.Y. Morgan Characteristics of minimal hepatic encephalopathy Metab Brain Dis 19 2004 253 267
46. M. McCrea, J. Cordoba, G. Vessey, A.T. Blei, and C. Randolph Neuropsycho-logical characterization and detection of subclinical hepatic encephalopathy Arch Neurol 53 1996 758 763
47. J. Wiltfang, W. Nolte, K. Weissenborn, J. Kornhuber, and E. Ruther Psychiatric aspects of portal-systemic encephalopathy Metab Brain Dis 13 1998 379 389
48. S. Montagnese, C. De Pitta, M. De Rui, M. Corrias, M. Turco, and C. Merkel et al. Sleep-wake abnormalities in patients with cirrhosis Hepatology 59 2014 705 712
49. J. Cordoba, J. Cabrera, L. Lataif, P. Penev, P. Zee, and A.T. Blei High prevalence of sleep disturbance in cirrhosis Hepatology 27 1998 339 345
50. S. Montagnese, B. Middleton, D.J. Skene, and M.Y. Morgan Night-time sleep disturbance does not correlate with neuropsychiatric impairment in patients with cirrhosis Liver Int 29 2009 1372 1382
51. K. Weissenborn Diagnosis of encephalopathy Digestion 59 1998 22 24
52. R.D. Adams, and J.M. Foley The neurological disorder associated with liver disease Res Publ Assoc Res Nerv Ment Dis 32 1953 198 237
53. J.F. Cadranel, E. Lebiez, V. Di Martino, B. Bernard, S. El Koury, and A. Tourbah et al. Focal neurological signs in hepatic encephalopathy in cirrhotic patients: an underestimated entity? Am J Gastroenterol 96 2001 515 518
54. N. Delanty, J.A. French, D.R. Labar, T.A. Pedley, and A.J. Rowan Status epilepticus arising de novo in hospitalized patients: an analysis of 41 patients Seizure 10 2001 116 119
55. N. Eleftheriadis, E. Fourla, D. Eleftheriadis, and A. Karlovasitou Status epilepticus as a manifestation of hepatic encephalopathy Acta Neurol Scand 107 2003 142 144
56. S. Prabhakar, and R. Bhatia Management of agitation and convulsions in hepatic encephalopathy Indian J Gastroenterol 22 2003 S54 S58
57. K. Weissenborn, M. Bokemeyer, J. Krause, J. Ennen, and B. Ahl Neurological and neuropsychiatric syndromes associated with liver disease AIDS 19 2005 S93 S98
58. A.E. Read, S. Sherlock, J. Laidlaw, and J.G. Walker The neuro-psychiatric syndromes associated with chronic liver disease and an extensive portal-systemic collateral circulation Q J Med 141 1967 135 150
59. U. Baccarani, E. Zola, G.L. Adani, M. Cavalletti, S. Schiff, and A. Cagnin et al. Reversal of hepatic myelopathy after liver transplantation: fifteen plus one Liver Transpl 16 2010 1336 1337
60. M. Victor, R.D. Adams, and M. Cole The acquired (non Wilsonian) type of chronic hepatocerebral degeneration Medicine 44 1965 345 396
61. A.B. Tryc, A. Goldbecker, G. Berding, S. Rümke, K. Afshar, and G.H. Shahrezaei et al. Cirrhosis-related Parkinsonism: prevalence, mechanisms and response to treatments J Hepatol 58 2013 698 705
62. W.M. Lee, R.T. Stravitz, and A.M. Larson Introduction to the revised American Association for the Study of Liver Diseases Position Paper on acute liver failure 2011 Hepatology 55 2012 965 967
63. J. Cordoba, M. Ventura-Cots, M. Simón-Talero, A. Amorós, M. Pavesi, and H. Vilstrup et al. CANONIC Study Investigators of the EASL-CLIF Consortium. Characteristics, risk factors, and mortality of cirrhotic patients hospitalized for hepatic encephalopathy with and without acute-on-chronic liver failure (ACLF) J Hepatol 60 2014 275 281
64. J.S. Bajaj, J.B. Wade, and A.J. Sanyal Spectrum of neurocognitive impairment in cirrhosis: implications for the assessment of hepatic encephalopathy Hepatology 50 2009 2014 2021
65. J.S. Bajaj, J. Cordoba, K.D. Mullen, P. Amodio, D.L. Shawcross, and R.F. Butterrworth et al. Review article: the design of clinical trials in hepatic encephalopathy - an International Society for Hepatic Encephalopathy and Nitrogen Metabolism (ISHEN) consensus statement Aliment Pharmacol Ther 33 2011 739 747
66. S. Montagnese, P. Amodio, and M.Y. Morgan Methods for diagnosing hepatic encephalopathy in patients with cirrhosis: a multidimensional approach Metab Brain Dis 19 2004 281 312
67. R. Prakash, and K.D. Mullen Mechanisms, diagnosis and management of hepatic encephalopathy Nat Rev Gastroenterol Hepatol 7 2010 515 525
68. T.I. Hassanein, R.C. Hilsabeck, and W. Perry Introduction to the Hepatic Encephalopathy Scoring Algorithm (HESA) Dig Dis Sci 53 2008 529 538
69. J.M. Guerit, A. Amantini, C. Fischer, P.W. Kaplan, O. Mecarelli, and A. Schnitzler et al. Neurophysiological investigations of hepatic encephalopathy: ISHEN practice guidelines Liver Int 29 2009 789 796
70. C. Randolph, R. Hilsabeck, A. Kato, P. Kharbanda, Y.Y. Li, and D. Mapelli et al. Neuropsychological assessment of hepatic encephalopathy: ISHEN practice guidelines Liver Int 29 2009 629 635
71. M.M. Lauridsen, P. Jepsen, and H. Vilstrup Critical flicker frequency and continuous reaction times for the diagnosis of minimal hepatic encephalopathy: a comparative study of 154 patients with liver disease Metab Brain Dis 26 2011 135 139
72. J.S. Bajaj, S.D. Pinkerton, A.J. Sanyal, and D.M. Heuman Diagnosis and treatment of minimal hepatic encephalopathy to prevent motor vehicle accidents: a cost-effectiveness analysis Hepatology 55 2012 1164 1171
73. M. Ortiz, C. Jacas, and J. Cordoba Minimal hepatic encephalopathy: diagnosis, clinical significance and recommendations J Hepatol 42 2005 S45 S53
74. J.S. Bajaj, P.M. Gillevet, N.R. Patel, V. Ahluwalia, J.M. Ridlon, and B. Kettenmann et al. A longitudinal systems biology analysis of lactulose withdrawal in hepatic encephalopathy Metab Brain Dis 27 2012 205 215
75. K. Weissenborn, J.C. Ennen, H. Schomerus, N. Ruckert, and H. Hecker Neuropsychological characterization of hepatic encephalopathy J Hepatol 34 2001 768 773
76. R.K. Prakash, T.A. Brown, and K.D. Mullen Minimal hepatic encephalopathy and driving: is the genie out of the bottle? Am J Gastroenterol 106 2011 1415 1416
77. J.S. Bajaj, A.C. Stein, and R.M. Dubinsky What is driving the legal interest in hepatic encephalopathy? Clin Gastroenterol Hepatol 9 2011 97 98
78. R.K. Dhiman, V.A. Saraswat, M. Verma, and S.R. Naik Figure connection test: a universal test for assessment of mental state J Gastroenterol Hepatol 10 1995 14 23
79. G. Kircheis, M. Wettstein, L. Timmermann, A. Schnitzler, and D. Haussinger Critical flicker frequency for quantification of low-grade hepatic encephalopathy Hepatology 35 2002 357 366
80. M. Romero-Gomez, J. Cordoba, R. Jover, J.A. del Olmo, M. Ramirez, and R. Rey et al. Value of the critical flicker frequency in patients with minimal hepatic encephalopathy Hepatology 45 2007 879 885
81. M.M. Lauridsen, M. Thiele, N. Kimer, and H. Vilstrup The continuous reaction times method for diagnosing, grading, and monitoring minimal/covert hepatic encephalopathy Metab Brain Dis 28 2013 231 234
82. J.S. Bajaj, M. Hafeezullah, J. Franco, R.R. Varma, R.G. Hoffmann, and J.F. Knox et al. Inhibitory control test for the diagnosis of minimal hepatic encephalopathy Gastroenterology 135 2008 1591 1600
83. J.S. Bajaj, L.R. Thacker, D.M. Heumann, M. Fuchs, R.K. Sterling, and A.J. Sanyal et al. The Stroop smartphone application is a short and valid method to screen for minimal hepatic encephalopathy Hepatology 58 2013 1122 1132
84. P. Amodio, F. Del Piccolo, P. Marchetti, P. Angeli, R. Iemmolo, and L. Caregaro et al. Clinical features and survival of cirrhotic patients with sub-clinical cognitive alterations detected by the number connection test and computerized psychometric tests Hepatology 29 1999 1662 1667
85. S. Montagnese, A. Biancardi, S. Schiff, P. Carraro, V. Carla, and G. Mannaioni et al. Different biochemical correlates for different neuropsychiatric abnormalities in patients with cirrhosis Hepatology 53 2010 558 566
86. A.H. Lockwood Blood ammonia levels and hepatic encephalopathy Metab Brain Dis 19 2004 345 349
87. H. Grønbaek, S.P. Johnsen, P. Jepsen, M. Gislum, H. Vilstrup, and U. Tage-Jensen et al. Liver cirrhosis, other liver diseases, and risk of hospitalisation for intracerebral haemorrhage: a Danish population-based case-control study BMC Gastroenterol 8 2008 16
88. E. Strauss, R. Tramote, E.P. Silva, W.R. Caly, N.Z. Honain, and R.A. Maffei et al. Double-blind randomized clinical trial comparing neomycin and placebo in the treatment of exogenous hepatic encephalopathy Hepatogastroenterology 39 1992 542 545
89. B. Als-Nielsen, L.L. Gluud, and C. Gluud Non-absorbable disaccharides for hepatic encephalopathy: systematic review of randomised trials BMJ 328 2004 1046
90. O. Riggio, M. Varriale, G.P. Testore, R. Di Rosa, E. Di Rosa, and M. Merli et al. Effect of lactitol and lactulose administration on the fecal flora in cirrhotic patients J Clin Gastroenterol 12 1990 433 436
91. E. Huang, E. Esrailian, and B.M. Spiegel The cost-effectiveness and budget impact of competing therapies in hepatic encephalopathy - a decision analysis Aliment Pharmacol Ther 26 2007 1147 1161
92. C. Camma, F. Fiorello, F. Tine, G. Marchesini, A. Fabbri, and L. Pagliaro Lactitol in treatment of chronic hepatic encephalopathy. A meta-analysis Dig Dis Sci 38 1993 916 922
93. M.Y. Morgan, K.E. Hawley, and D. Stambuk Lactitol vs. lactulose in the treatment of chronic hepatic encephalopathy. A double-blind, randomised, cross-over study J Hepatol 4 1987 236 244
94. M. Uribe, J.M. Berthier, H. Lewis, J.M. Mata, J.G. Sierra, and G. García-Ramos et al. Lactose enemas plus placebo tablets vs. neomycin tablets plus starch enemas in acute portal systemic encephalopathy. A double-blind randomized controlled study Gastroenterology 81 1981 101 106
95. M. Uribe, O. Campollo, F. Vargas, G.P. Ravelli, F. Mundo, and L. Zapata et al. Acidifying enemas (lactitol and lactose) vs. nonacidifying enemas (tap water) to treat acute portal-systemic encephalopathy: a double-blind, randomized clinical trial Hepatology 7 1987 639 643
96. R.S. Rahimi, A.G. Singal, J.A. Cuthbert, and D.G. Rockey A randomized trial of polyethylene glycol 3350-electrolyte solution (PEG) and lactulose for patients hospitalized with acute hepatic encephalopathy Hepatology 56 2012 915A 916A [abstr. 1546]
97. J.S. Bajaj, A.J. Sanyal, D. Bell, H. Gilles, and D.M. Heuman Predictors of the recurrence of hepatic encephalopathy in lactulose-treated patients Aliment Pharmacol Ther 31 2010 1012 1017
98. K.R. Patidar, and J.S. Bajaj Antibiotics for the treatment of hepatic encephalopathy Metab Brain Dis 28 2013 307 312
99. N.M. Bass, K.D. Mullen, A. Sanyal, F. Poordad, G. Neff, and C.B. Leevy et al. Rifaximin treatment in hepatic encephalopathy N Engl J Med 362 2010 1071 1081
100. L.L. Gluud, G. Dam, M. Borre, I. Les, J. Cordoba, and G. Marchesini et al. Lactulose, rifaximin or branched chain amino acids for hepatic encephalopathy: what is the evidence? Metab Brain Dis 28 2013 221 225
101. M. Ventura-Cots, J.A. Arranz, M. Simón-Talero, M. Torrens, A. Blanco, and E. Riudor et al. Safety of ornithine phenylacetate in cirrhotic decompensated patients: an open-label, dose-escalating, single-cohort study J Clin Gastroenterol 47 2013 881 887
102. D.C. Rockey, J.M. Vierling, P. Mantry, M. Ghabril, R.S. Brown Jr., and O. Alexeeva et al. HALT-HE Study Group. Randomized, double-blind, controlled study of glycerol phenylbutyrate in hepatic encephalopathy Hepatology 59 2014 1073 1083
103. G. Kircheis, R. Nilius, C. Held, H. Berndt, M. Buchner, and R. Gortelmeyer et al. Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study Hepatology 25 1997 1351 1360
104. A. Agrawal, B.C. Sharma, P. Sharma, and S.K. Sarin Secondary prophylaxis of hepatic encephalopathy in cirrhosis: an open-label, randomized controlled trial of lactulose, probiotics, and no therapy Am J Gastroenterol 107 2012 1043 1050
105. R.A. Hawkins, J. Jessy, A.M. Mans, A. Chedid, and M.R. DeJoseph Neomycin reduces the intestinal production of ammonia from glutamine Adv Exp Med Biol 368 1994 125 134
106. M.H. Morgan, A.E. Read, and D.C. Speller Treatment of hepatic encephalopathy with metronidazole Gut 23 1982 1 7
107. M. Simón-Talero, R. García-Martínez, M. Torrens, S. Augustin, S. Gómez, and G. Pereira et al. Effects of intravenous albumin in patients with cirrhosis and episodic hepatic encephalopathy: a randomized double-blind study J Hepatol 59 2013 1184 1192
108. P. Sharma, A. Agrawal, B.C. Sharma, and S.K. Sarin Prophylaxis of hepatic encephalopathy in acute variceal bleed: a randomized controlled trial of lactulose vs. no lactulose J Gastroenterol Hepatol 26 2011 996 1003
109. O. Riggio, A. Masini, C. Efrati, F. Nicolao, S. Angeloni, and F.M. Salvatori et al. Pharmacological prophylaxis of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt: a randomized controlled study J Hepatol 42 2005 674 679
110. F. Fanelli, F.M. Salvatori, P. Rabuffi, E. Boatta, O. Riggio, and P. Lucatelli et al. Management of refractory hepatic encephalopathy after insertion of TIPS: long-term results of shunt reduction with hourglass-shaped balloon-expandable stent-graft AJR Am J Roentgenol 193 2009 1696 1702
111. H.H. Chung, M.K. Razavi, D.Y. Sze, J.K. Frisoli, S.T. Kee, and M.D. Dake et al. Portosystemic pressure gradient during transjugular intrahepatic portosystemic shunt with Viatorr stent graft: what is the critical low threshold to avoid medically uncontrolled low pressure gradient related complications? J Gastroenterol Hepatol 23 2008 95 101
112. W. Laleman, M. Simon-Talero, G. Maleux, M. Perez, K. Ameloot, G. Soriano on behalf of the EASL-CLIF-Consortium Embolization of large spontaneous portosystemic shunts for refractory hepatic encephalopathy: a multi-center survey on safety and efficacy Hepatology 57 2013 2448 2457
113. P. Sharma, B.C. Sharma, A. Agrawal, and S.K. Sarin Primary prophylaxis of overt hepatic encephalopathy in patients with cirrhosis: an open labeled randomized controlled trial of lactulose vs. no lactulose J Gastroenterol Hepatol 27 2012 1329 1335
114. S.S. Sidhu, O. Goyal, B.P. Mishra, A. Sood, R.S. Chhina, and R.K. Soni Rifaximin improves psychometric performance and health-related quality of life in patients with minimal hepatic encephalopathy (the RIME Trial) Am J Gastroenterol 106 2011 307 316
115. J.S. Bajaj, D.M. Heuman, J.B. Wade, D.P. Gibson, K. Saeian, and J.A. Wegelin et al. Rifaximin improves driving simulator performance in a randomized trial of patients with minimal hepatic encephalopathy Gastroenterology 140 2011 478 487
116. J.S. Bajaj, K. Saeian, K.M. Christensen, M. Hafeezullah, R.R. Varma, and J. Franco et al. Probiotic yogurt for the treatment of minimal hepatic encephalopathy Am J Gastroenterol 103 2008 1707 1715
117. V.V. Mittal, B.C. Sharma, P. Sharma, and S.K. Sarin A randomized controlled trial comparing lactulose, probiotics, and L-ornithine L-aspartate in treatment of minimal hepatic encephalopathy Eur J Gastroenterol Hepatol 23 2011 725 732
118. S. Saji, S. Kumar, and V. Thomas A randomized double blind placebo controlled trial of probiotics in minimal hepatic encephalopathy Trop Gastroenterol 32 2011 128 132
119. S. Shukla, A. Shukla, S. Mehboob, and S. Guha Meta-analysis: the effects of gut flora modulation using prebiotics, probiotics and synbiotics on minimal hepatic encephalopathy Aliment Pharmacol Ther 33 2011 662 671
120. P. Amodio, C. Bemeur, R. Butterworth, J. Cordoba, A. Kata, and S. Montagnese et al. The nutritional management of hepatic encephalopathy in patients with cirrhosis: ISHEN practice guidelines Hepatology 58 2013 325 336
121. A.J. Montano-Loza, J. Meza-Junco, C.M. Prado, J.R. Lieffers, V.E. Baracos, and V.G. Bain et al. Muscle wasting is associated with mortality in patients with cirrhosis Clin Gastroenterol Hepatol 10 2012 166 173
122. P. Tandon, M. Ney, I. Irwin, M.M. Ma, L. Gramlich, and V.G. Bain et al. Severe muscle depletion in patients on the liver transplant wait list: its prevalence and independent prognostic value Liver Transpl 18 2012 1209 1216
123. C.D. Tsien, A.J. McCullough, and S. Dasarathy Late evening snack: exploiting a period of anabolic opportunity in cirrhosis J Gastroenterol Hepatol 27 2012 430 441
124. S. Ndraha, I. Hasan, and M. Simadibrata The effect of L-ornithine L-aspartate and branch chain amino acids on encephalopathy and nutritional status in liver cirrhosis with malnutrition Acta Med Indones 43 2011 18 22
125. C.D. Naylor, K. O'Rourke, A.S. Detsky, and J.P. Baker Parenteral nutrition with branched-chain amino acids in hepatic encephalopathy. A meta-analysis Gastroenterology 97 1989 1033 1042
126. G. Marchesini, G. Bianchi, M. Merli, P. Amodio, C. Panella, and C. Loguercio et al. Nutritional supplementation with branched-chain amino acids in advanced cirrhosis: a double-blind, randomized trial Gastroenterology 124 2003 1792 1801
127. G. Marchesini, R. Marzocchi, M. Noia, and G. Bianchi Branched-chain amino acid supplementation in patients with liver diseases J Nutr 135 2005 1596S 1601S
128. L.L. Gluud, G. Dam, M. Borre, I. Les, J. Cordoba, and G. Marchesini et al. Oral branched chain amino acids have a beneficial effect on manifestations of hepatic encephalopathy in a systematic review with meta-analyses of randomized controlled trials J Nutr 143 2013 1263 1268
129. P. Martin, A. DiMartini, S. Feng, R. Brown Jr., and M. Fallon Evaluation for liver transplantation in adults: 2013 Practice Guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation Hepatology 59 2014 1144 1165
130. M.R. Lucey, N. Terrault, L. Ojo, J.E. Hay, J. Neuberger, and E. Blumberg et al. Long-term management of the successful adult liver transplant: 2012 Practice Guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation Liver Transpl 19 2013 3 26
131. J.I. Herrero, J.I. Bilbao, M.L. Diaz, F. Alegre, M. Inarrairaegui, and F. Pardo et al. Hepatic encephalopathy after liver transplantation in a patient with a normally functioning graft: treatment with embolization of portosystemic collaterals Liver Transpl 15 2009 111 114
132. L. Chavarria, J. Alonso, R. García-Martínez, M. Simón-Talero, M. Ventura-Cots, and C. Ramírez et al. Brain magnetic resonance spectroscopy in episodic hepatic encephalopathy J Cereb Blood Flow Metab 33 2013 272 277
133. R. Garcia-Martinez, A. Rovira, J. Alonso, C. Jacas, M. Simón-Talero, and L. Chavarria et al. Hepatic encephalopathy is associated with posttransplant cognitive function and brain volume Liver Transpl 17 2011 38 46
134. P. Amodio, A. Biancardi, S. Montagnese, P. Angeli, P. Iannizzi, and U. Cillo et al. Neurological complications after orthotopic liver transplantation Dig Liver Dis 39 2007 740 747
135. F.F. Poordad Review article: the burden of hepatic encephalopathy Aliment Pharmacol Ther 25 2007 3 9
136. J.S. Bajaj, J.B. Wade, D.P. Gibson, D.M. Heuman, L.R. Thacker, and R.K. Sterling et al. The multi-dimensional burden of cirrhosis and hepatic encephalopathy on patients and caregivers Am J Gastroenterol 106 2011 1646 1653
137. G.W. Neff, N. Kemmer, V.C. Zacharias, T. Kaiser, C. Duncan, and R. McHenry et al. Analysis of hospitalizations comparing rifaximin vs. lactulose in the management of hepatic encephalopathy Transplant Proc 38 2006 3552 3555
138. M. Guevara, M.E. Baccaro, A. Torre, B. Gómez-Ansón, J. Rìos, and F. Torres et al. Hyponatremia is a risk factor of hepatic encephalopathy in patients with cirrhosis: a prospective study with time-dependent analysis Am J Gastroenterol 104 2009 1382 1389
139. M. Guevara, M.E. Baccaro, J. Ríos, M. Martín-Llahí, J. Uriz, and L. Ruiz del Arbol et al. Risk factors for hepatic encephalopathy in patients with cirrhosis and refractory ascites: relevance of serum sodium concentration Liver Int 30 2010 1137 1142
140. P. Angeli, F. Wong, H. Watson, and P. Gines Hyponatremia in cirrhosis: results of a patient population survey Hepatology 44 2006 1535 1542
141. P. Sharma, B.C. Sharma, and S.K. Sarin Predictors of nonresponse to lactulose for minimal hepatic encephalopathy in patients with cirrhosis Liver Int 29 2009 1365 1371
142. S.H. Sigal, C.M. Stanca, N. Kontorinis, C. Bodian, and E. Ryan Diabetes mellitus is associated with hepatic encephalopathy in patients with HCV cirrhosis Am J Gastroenterol 101 2006 1490 1496
143. E. Kalaitzakis, R. Olsson, P. Henfridsson, I. Hugosson, M. Bengtsson, and R. Jalan et al. Malnutrition and diabetes mellitus are related to hepatic encephalopathy in patients with liver cirrhosis Liver Int 27 2007 1194 1201
144. E. Kalaitzakis, and E. Bjornsson Renal function and cognitive impairment in patients with liver cirrhosis Scand J Gastroenterol 42 2007 1238 1244
145. T. Gustot, F. Durand, D. Lebrec, J.L. Vincent, and R. Moreau Severe sepsis in cirrhosis Hepatology 50 2009 2022 2032
146. G.B. Young, C.F. Bolton, T.W. Austin, Y.M. Archibald, J. Gonder, and G.A. Wells The encephalopathy associated with septic illness Clin Invest Med 13 1990 297 304
147. R.F. Butterworth Thiamine deficiency-related brain dysfunction in chronic liver failure Metab Brain Dis 24 2009 189 196
148. A.L. Pitel, H. Beaunieux, T. Witkowski, F. Vabret, B. Guillery-Girard, and P. Quinette et al. Genuine episodic memory deficits and executive dysfunctions in alcoholic subjects early in abstinence Alcohol Clin Exp Res 31 2007 1169 1178
149. X. Noel, M. Van der Linden, N. Schmidt, R. Sferrazza, C. Hanak, and O. Le Bon et al. Supervisory attentional system in nonamnestic alcoholic men Arch Gen Psychiatry 58 2001 1152 1158
150. L.K. Dawson, and I. Grant Alcoholics' initial organizational and problem-solving skills predict learning and memory performance on the Rey-Osterrieth Complex Figure J Int Neuropsychol Soc 6 2000 12 19
151. E.V. Sullivan, M.J. Rosenbloom, and A. Pfefferbaum Pattern of motor and cognitive deficits in detoxified alcoholic men Alcohol Clin Exp Res 24 2000 611 621
152. A.L. Pitel, N.M. Zahr, K. Jackson, S.A. Sassoon, M.J. Rosenbloom, and A. Pfefferbaum et al. Signs of preclinical Wernicke's encephalopathy and thiamine levels as predictors of neuropsychological deficits in alcoholism without Korsakoff's syndrome Neuropsychopharmacology 36 2011 580 588
153. T. Laskus, M. Radkowski, A. Bednarska, J. Wilkinson, D. Adair, and M. Nowicki et al. Detection and analysis of hepatitis C virus sequences in cerebrospinal fluid J Virol 76 2002 10064 10068
154. D.M. Forton, P. Karayianni, N. Mahmud, S.D. Taylor-Robinson, and H.C. Thomas Identification of unique hepatitis C virus quasispecies in the central nervous system and comparative analysis of internal translational efficiency of brain, liver, and serum variants J Virol 78 2004 5170 5183
155. S.L. Fishman, J.M. Murray, F.J. Eng, J.L. Walewski, S. Morgello, and A.D. Branch Molecular and bioinformatic evidence of hepatitis C virus evolution in brain J Infect Dis 197 2008 597 607
156. J. Wilkinson, M. Radkowski, and T. Laskus Hepatitis C virus neuroinvasion: identification of infected cells J Virol 83 2009 1312 1319
157. T. Poynard, P. Cacoub, V. Ratziu, R.P. Myers, M.H. Dezailles, and A. Mercadier et al. For the Multivirc Group. Fatigue in patients with chronic hepatitis C J Viral Hepat 9 2002 295 303
158. Z. Hassoun, B. Willems, J. Deslauriers, B.N. Nguyen, and P.M. Huet Assessment of fatigue in patients with chronic hepatitis C using the fatigue impact scale Dig Dis Sci 47 2002 2674 2681
159. D.M. Forton, H.C. Thomas, C.A. Murphy, J.M. Allsop, G.R. Foster, and J. Main et al. Hepatitis C and cognitive impairment in a cohort of patients with mild liver disease Hepatology 35 2002 433 439
160. K. Weissenborn, J. Krause, M. Bokemeyer, H. Hecker, A. Schüler, and J.C. Ennen et al. Hepatitis C virus infection affects the brain - evidence from psychometric studies and magnetic resonance spectroscopy J Hepatol 41 2004 845 851
161. R.E. Tarter, A.M. Hegedus, D.H. Van Thiel, N. Edwards, and R.R. Schade Neurobehavioral correlates of cholestatic and hepatocellular disease: dif
162. R.E. Tarter, A.L. Hays, J. Carra, K.L. Edwards, and D.H. Van Thiel Sjogren's syndrome. Its contribution to neuropsychiatric syndrome in patients with primary biliary cirrhosis Dig Dis Sci 34 1989 9 12
163. J.L. Newton, K.G. Hollingsworth, R. Taylor, A.M. El-Sharkawy, Z.U. Khan, and R. Pearce et al. Cognitive impairment in primary biliary cirrhosis: symptom impact and potential etiology Hepatology 48 2008 541 549
164. A. Jacoby, A. Rannard, D. Buck, N. Bhala, J.L. Newton, and O.F.W. James et al. Development, validation and evaluation of the PBC-40, a disease specific health related quality of life measure for primary biliary cirrhosis Gut 54 2005 1622 1629
165. J.L. Newton, N. Bhala, J. Burt, and D.E.J. Jones Characterisation of the associations and impact of symptoms in primary biliary cirrhosis using a disease specific quality of life measure J Hepatol 44 2006 776 782
166. J.L. Newton, J.G. Gibson, M. Tomlinson, K. Wilton, and D.E.J. Jones Fatigue in primary biliary cirrhosis is associated with excessive daytime somnolence Hepatology 44 2006 91 98
167. G. Teasdale, and B. Jennett Assessment of coma and impaired consciousness: a practical scale Lancet 2 1974 81 84