Behaviour disorders and psychotic symptoms in liver diseases – a review article
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Klinika Chorób Wewnętrznych, Uniwersytet Medyczny, Lublin
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Andrzej Prystupa
Katedra i Klinika Chorób Wewnętrznych, Uniwersytet Medyczny w Lublinie, ul. Staszica 16, 20-081 Lublin
Med Og Nauk Zdr. 2013;19(2):135-137
Hepatic encephalopathy (HE) is a reversible, neuropsychiatric complication of acute or chronic liver failure. Advancement of encephalopathy is defined by the West-Haven scale which distinguishes five degrees of severity (0–4). Clinically, overt HE is preceded by minimal alterations of cerebral function, only detectable by neuropsychological or neurophysiological measures, but which, nevertheless, interfere with the patient’s daily living. Importantly, minimal hepatic encephalopathy (MHE) has a profound negative impact on the ability to drive a car and may be a significant factor behind motor vehicle accidents. Detection and treatment of MHE has the potential to reduce costs associated with motor vehicle accidents. The earliest prognostic signs of hepatic encephalopathy include circadian dysfunction of the sleep and wakefulness rhythm, such as insomnia at night and drowsiness during the day. Sleep disturbances have recently been shown to be an important prognostic factor in patients with advanced chronic liver disease. Although mental changes are frequent in Wilson’s disease, severe psychiatric disorders occur uncommonly and usually accompany the neurological symptoms. There are few reports in the literature of Wilson’s disease patients with typical bipolar affective disorder (BPAD). Key words: hepatic encephalopathy, sleep disorders, Wilson’s disease

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