SUBCLINICAL ENCEPHALOPATHY

Subclinical hepatic encephalopathy (SHE) - cognitive deficits in the a bsence of overt encephalopathy - is frequently present in patients wit h cirrhosis. In the absence of biological correlates, diagnosis of SHE relies on psychometric tests. Attentional and motor abnormalities are the most common neurocognitive deficits. Sleep disturbances - a frequ ent complaint in cirrhosis - may be part of the spectrum of SHE. The i mpact of SHE on daily activities is controversial as patients may adap t their lives to cognitive limitations. Demanding activities, such as driving motor vehicles, may be impaired, though a blanket restriction appears premature. The benefit of treating SHE is not established. Ant iencephalopathic drugs may be effective and can be considered in certa in individuals.