Chronic acquired hepatocerebral degeneration: effects of liver transplantation on neurological manifestations

Neurol Sci. 2011 Jun;32(3):411-5. doi: 10.1007/s10072-011-0481-z. Epub 2011 Feb 17.

Abstract

Three cirrhotic patients with chronic acquired hepatocerebral degeneration (CAHD) received neurologic, neuropsychologic and neuroimaging assessment before and after liver transplantation (LT). Before transplantation, neurologic dysfunction consisted in severe bradykinesia, dystonia, dyskinesia, ataxia and dysarthria. Cognitive impairment affected mainly attentional and executive domains. Brain MRI showed bilateral hyperintensities of the basal ganglia on T1-weighted images. After transplantation, motor manifestations promptly resolved. Cognitive testing showed a major improvement in two patients, whereas cognitive performances were slightly worsened in the third, reasonably due to the effects of a head injury before LT and a tacrolimus-related encephalopathy arising early after LT. MRI images 12 months later showed a slight reduction of the previously disclosed abnormalities in all three patients. None of them experienced recurrence of CAHD. Our observation reinforces the assumption that surgery is the best treatment option for CAHD and that severe neurological impairment in CAHD should not be considered a contraindication for LT.

Publication types

  • Case Reports

MeSH terms

  • Chronic Disease
  • Hepatolenticular Degeneration / etiology*
  • Hepatolenticular Degeneration / pathology
  • Hepatolenticular Degeneration / surgery*
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / surgery*
  • Liver Transplantation / methods*
  • Liver Transplantation / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged