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Q J Med 2003; 96: 623-633
© 2003 Association of Physicians

Review

The neurology of liver failure

M. Lewis and P.D. Howdle

From the Academic Unit of Medicine, St James’s University Hospital, Leeds, UK

The first 150 words of the full text of this article appear below.


   Introduction
 
That there is a relationship between the brain and the liver has been known for many years,1 and patients with chronic liver disease frequently experience neurological problems. The commonest and most widely recognized is the reversible syndrome of hepatic encephalopathy,2 and we will deal with this in some detail. There are also of course many conditions that affect both the liver and the nervous system, Wilson’s disease being one of the best known.2–8 This condition is a genetic disorder of copper metabolism; the abnormal gene is located on chromosome 139 and most of the symptoms seem to be due directly to the deposition of copper in various organs. Patients typically present early with liver disease or later with the neurological syndrome,2 which consists of various subtle neuropsychiatric symptoms such as a change in behaviour or performance at school10 and abnormality of movement.3,4 There are many other conditions where the brain . . . [Full Text of this Article]


   Overt hepatic encephalopathy
 

   Minimal hepatic encephalopathy
 

   Hepatic encephalopathy and liver transplantation
 

   Fulminant hepatic failure
 

   Acquired hepatocerebral degeneration and hepatic myelopathy
 

   Osmotic demyelination disorders
 

   Other neurological disorders in liver disease
 

   Neuroimaging abnormalities associated with liver disease
 

   Conclusions
 

Address correspondence to Dr M. Lewis, 68 Savile Road, Methley, Leeds LS26 9HW. e-mail: m-k-lewis@email.msn.com


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