Hepatische Enzephalopathie


The occurrence of hepatic encephalopathy (HE) is a frequent neuropsychiatric complication in patients with liver cirrhosis. HE impairs quality of life and is a sign for poor prognosis. A decrease in the detoxifying function of the liver and a subsequent increase of toxic substances in the blood, i.e. ammonia, is considered as one cause for the development of HE. Among others a protein-rich diet accompanied by a higher ammonia production is discussed as one possible trigger for HE. While a clinically manifest HE can be diagnosed simply and reliably, the identification and quantification of a latent or subclinical HE is challenging due to the insufficient methods. In addition to psychomtric tests (number connection test, line tracing test) available at present, a new diagnostic tool was recently introduced, which measures the visual discrimination ability of the brain using light of different frequencies which is percieved as flickering or fused light. This diagnostic tool will be established in patients with liver cirrhosis which are at risk of deteriorating HE due to the course of their disease or due to therapy.
Head of Project:

PD.Dr. Johann Ockenga
Charité - Universitätsmedizin Berlin
Department of Internal Medicine, Gastroenterology and Hepatology CCM
Tel. 514034
Fax 514923
johann.ockenga@charite.de
Additional Member of Project:

Dr. rer. nat. Tatjana Schütz
Begin/End of Project:

04/2004 - 03/2008
Funded by:

Sonnenfeld-Stiftung
Publications:

Kircheis G, Wettstein M, Timmermann L, Schnitzler A, Haussinger D. Critical flicker frequency for quantification of low-grade hepaticencephalopathy. Hepatology. 2002 Feb;35(2):357-66. Ockenga J, Kroencke TJ, Schuetz T, Plauth M, Kasim E, Petersein J, Schmidt HH, Lochs H. Covered transjugular intrahepatic portosystemic stents maintain lower portal pressure and require fewer reinterventions than uncovered stents. Scand J Gastroenterol. 2004 Oct;39(10):994-9. Plauth M, Schutz T, Buckendahl DP, Kreymann G, Pirlich M, Grungreiff S, Romaniuk P, Ertl S, Weiss ML, Lochs H. Weight gain after transjugular intrahepatic portosystemic shunt is associated with improvement in body composition in malnourished patients with cirrhosis and hypermetabolism. J Hepatol. 2004 Feb;40(2):228-33.