What is the presentation of minimal (covert) hepatic encephalopathy (HE)?

Updated: May 18, 2020
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: BS Anand, MD  more...
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The subject of minimal hepatic encephalopathy—also known as covert hepatic encephalopathy—has attracted increasing attention. Minimal hepatic encephalopathy describes a state of low-level cognitive dysfunction that is present in as many as 70% of patients with cirrhosis. [72] It may be marked by decreased attention and decision-making function, as well as depressed psychomotor speed and visuomotor activity. Typically, the patient and those around the patient, including physicians, are not aware that the condition is present. Minimal hepatic encephalopathy is detected through psychometric testing (eg, the number connection test, the digit symbol test, the block design test, reaction times to light or sound, and the reaction time to interference in a task). [73, 74, 75]

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