C. Wein et al., SUBCLINICAL HEPATIC-ENCEPHALOPATHY - APPL ICATION OF COMPUTER-ASSISTED PSYCHOMETRIC METHODS, Die medizinische Welt, 48(3-4), 1997, pp. 125-130
Subclinical hepatic encephalopathy ist the most frequent complication
of hepatic cirrhosis. Only psychometric test are able to detect these
cognitive disturbances during the talent stage of the disorder. Conven
tional paper and pencil tests are only partly suitable for diagnosing
these neuropsychological disturbances. A new psychometric test to reco
rd reaction limes and power of memory fully automatically, from testin
g to interpreation, has been developed and undergone trials. With comp
uter-assisted instrument it was possible to differentiate exactly betw
een patients with (n = 15) and without (n = 35) subclinical hepatic en
cephalopathy on the basis of the (longer) reaction times. The number o
f patients with subclinical hepatic encephalopathy increased significa
ntly in line with the severity of hepatic cirrhosis (Child-Pugh classi
fication) in spite of the fact that there was no correlation with ammo
nia levels or aetiology of cirrhosis. Patients with alcoholic cirrhosi
s showed significantly poorer memory, although they achieved the same
results in the reaction time tests as the rest of the group. The compu
ter-assisted test agrees closely with other modern diagnostic procedur
es for subclinical hepatic encephalopathy, but not with simple, less s
ensitive bedside tests.