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Prevalence of abnormal psychometric tests and critical flicker frequency after clinical recovery of overt hepatic encephalopathy.
Neurol India 2010 Mar-Apr; 58(2):220-4NI

Abstract

BACKGROUND

Abnormal psychometric tests are common in cirrhotic patients without overt encephalopathy. It may seriously impair the patient's daily functioning and quality of life. Prevalence of abnormal psychometric tests after the clinical recovery of overt encephalopathy has not been studied.

MATERIALS AND METHODS

Consecutive 80 patients (age, 44.5+/-9.8 yr; M: F 66:14) with hepatic encephalopathy (HE) who recovered and met inclusion criteria were evaluated for abnormal psychometric tests (> 2 SD) and critical flicker frequency (CFF < 38 Hz). All patients underwent number connection tests-A and B, figure connection tests -A and B (if illiterate), digit symbol test, object assembly test, CFF and arterial ammonia after one month of clinical recovery of HE.

RESULTS

Prevalence of abnormal psychometric tests (> 2SD) was seen in 58 (72.5%) patients. [33 (66%) of 50 patients on lactulose and 25 (83%) of 30 patients not on lactulose, P = 0.12]. Arterial ammonia was significantly higher in patients with abnormal psychometric tests compared to patients without it (86.3+/-22.2 vs 50.4+/-11.5 mmol/l, P = 0.01). CFF was < 38 Hz in 50 patients (62.5%). Patients with > or =2 abnormal psychometric tests had CFF significantly lower than with normal psychometric tests (35.6+/-2.3 vs 40.7+/-2.4 Hz, P = 0.001). CFF sensitivity and specificity in diagnosing > or =2 abnormal psychometric tests was 82 and 83% respectively. CFF was significantly correlated with psychometric tests [NCT-A (-0.672, P = 0.001) and B (-0.743, P = 0.001), digit symbol test (-0.533, P = 0.001), object assembly test (-0.659, P =0.001) and arterial ammonia level (-0.385, P = 0.02)].

CONCLUSION

About 73% of patients who recovered from HE had abnormal psychometric tests (> 2SD). CFF is a simple reliable tool to find out the presence of abnormal tests.

Authors+Show Affiliations

Department of Gastroenterology, G. B. Pant Hospital, New Delhi-110 002, India. drpraveen_sharma@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20508339

Citation

Sharma, Praveen, et al. "Prevalence of Abnormal Psychometric Tests and Critical Flicker Frequency After Clinical Recovery of Overt Hepatic Encephalopathy." Neurology India, vol. 58, no. 2, 2010, pp. 220-4.
Sharma P, Sharma BC, Sarin SK. Prevalence of abnormal psychometric tests and critical flicker frequency after clinical recovery of overt hepatic encephalopathy. Neurol India. 2010;58(2):220-4.
Sharma, P., Sharma, B. C., & Sarin, S. K. (2010). Prevalence of abnormal psychometric tests and critical flicker frequency after clinical recovery of overt hepatic encephalopathy. Neurology India, 58(2), pp. 220-4. doi:10.4103/0028-3886.63797.
Sharma P, Sharma BC, Sarin SK. Prevalence of Abnormal Psychometric Tests and Critical Flicker Frequency After Clinical Recovery of Overt Hepatic Encephalopathy. Neurol India. 2010;58(2):220-4. PubMed PMID: 20508339.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of abnormal psychometric tests and critical flicker frequency after clinical recovery of overt hepatic encephalopathy. AU - Sharma,Praveen, AU - Sharma,Barjesh Chander, AU - Sarin,Shiv Kumar, PY - 2010/5/29/entrez PY - 2010/5/29/pubmed PY - 2010/8/13/medline SP - 220 EP - 4 JF - Neurology India JO - Neurol India VL - 58 IS - 2 N2 - BACKGROUND: Abnormal psychometric tests are common in cirrhotic patients without overt encephalopathy. It may seriously impair the patient's daily functioning and quality of life. Prevalence of abnormal psychometric tests after the clinical recovery of overt encephalopathy has not been studied. MATERIALS AND METHODS: Consecutive 80 patients (age, 44.5+/-9.8 yr; M: F 66:14) with hepatic encephalopathy (HE) who recovered and met inclusion criteria were evaluated for abnormal psychometric tests (> 2 SD) and critical flicker frequency (CFF < 38 Hz). All patients underwent number connection tests-A and B, figure connection tests -A and B (if illiterate), digit symbol test, object assembly test, CFF and arterial ammonia after one month of clinical recovery of HE. RESULTS: Prevalence of abnormal psychometric tests (> 2SD) was seen in 58 (72.5%) patients. [33 (66%) of 50 patients on lactulose and 25 (83%) of 30 patients not on lactulose, P = 0.12]. Arterial ammonia was significantly higher in patients with abnormal psychometric tests compared to patients without it (86.3+/-22.2 vs 50.4+/-11.5 mmol/l, P = 0.01). CFF was < 38 Hz in 50 patients (62.5%). Patients with > or =2 abnormal psychometric tests had CFF significantly lower than with normal psychometric tests (35.6+/-2.3 vs 40.7+/-2.4 Hz, P = 0.001). CFF sensitivity and specificity in diagnosing > or =2 abnormal psychometric tests was 82 and 83% respectively. CFF was significantly correlated with psychometric tests [NCT-A (-0.672, P = 0.001) and B (-0.743, P = 0.001), digit symbol test (-0.533, P = 0.001), object assembly test (-0.659, P =0.001) and arterial ammonia level (-0.385, P = 0.02)]. CONCLUSION: About 73% of patients who recovered from HE had abnormal psychometric tests (> 2SD). CFF is a simple reliable tool to find out the presence of abnormal tests. SN - 0028-3886 UR - https://www.unboundmedicine.com/medline/citation/20508339/Prevalence_of_abnormal_psychometric_tests_and_critical_flicker_frequency_after_clinical_recovery_of_overt_hepatic_encephalopathy_ L2 - http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2010;volume=58;issue=2;spage=220;epage=224;aulast=Sharma DB - PRIME DP - Unbound Medicine ER -