LONG-LATENCY EVENT-RELATED POTENTIALS IN ACUTE HEPATITIS PATIENTS WITH SEVERE COAGULOPATHY

In 19 acute hepatitis patients with severe coagulopathy who were fully alert and oriented without any changes of mood or behavior, the P300 latency and the arterial blood ketone body ratio (KBR) were assessed a s predictors of fulminant hepatitis. All 5 patients developing fulmina nt hepatitis had a corrected P300 latency longer than 345 msec and 4 o f them had a KBR below 0.6. There was a significant negative correlati on between the KBR and the blood ammonia level and between the KBR and the corrected P300 latency, while there was a positive correlation be tween the blood ammonia level and the corrected P300 latency. These da ta suggest that hepatic encephalopathy develops when loss of hepatic d etoxifying activity allows toxic substances to reach the brain and ind uce cerebral edema. Our findings also suggest the clinical value of us ing the P300 latency combined with the KBR as predictors of fulminant hepatitis.