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Minimal hepatic encephalopathy: Consensus statement of a working party of the Indian National Association for Study of the Liver
Authors:Radha K Dhiman  Vivek A Saraswat  Barjesh K Sharma  Shiv K Sarin  Yogesh K Chawla  Roger Butterworth  Ajay Duseja  Rakesh Aggarwal  Deepak Amarapurkar  Praveen Sharma  Kaushal Madan  Samir Shah  Avnish K Seth  Rakesh K Gupta  Abraham Koshy  Ramesh R Rai  Jang B. Dilawari  Sri Prakash Mishra  Subrat K Acharya
Affiliation:1. Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh, India, and;2. Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India, and;3. Department of Gastroenterology, GB Pant Hospital, India,;4. Institute of Liver & Biliary Sciences, India,;5. Neuroscience Research Unit, H?pital Saint‐Luc, University of Montreal, Montreal, Quebec, Canada;6. and;7. Bombay Hospital & Medical Research Centre, India,;8. Jaslok Hospital & Research Centre, Mumbai, India, and;9. Army Hospital Research & Referral, India,;10. Department of Hepatology Lakeshore Hospital, Kochi, India, and;11. Sawai Madho Singh Medical College, Jaipur, India, and;12. Department of Gastroenterology, Inver Clyde Royal Hospital, Greenock, UK;13. Motilal Nehru Medical College, University of Allahabad, Allahabad, India;14. All India Institute of Medical Sciences, New Delhi, India, and
Abstract:Hepatic encephalopathy (HE) is a major complication that develops in some form and at some stage in a majority of patients with liver cirrhosis. Overt HE occurs in approximately 30–45% of cirrhotic patients. Minimal HE (MHE), the mildest form of HE, is characterized by subtle motor and cognitive deficits and impairs health‐related quality of life. The Indian National Association for Study of the Liver (INASL) set up a Working Party on MHE in 2008 with a mandate to develop consensus guidelines on various aspects of MHE relevant to clinical practice. Questions related to the definition of MHE, its prevalence, diagnosis, clinical characteristics, pathogenesis, natural history and treatment were addressed by the members of the Working Party.
Keywords:critical clicker frequency  health‐related quality of life  hepatic encephalopathy  lactulose  minimal hepatic encephalopathy  psychometric hepatic encephalopathy score  psychometry
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