"Acquired hepatocerebral degeneration" is a rare syndrome characterized by extrapiramidal symptomathology in patients affected by liver complaint with porta-cava shunt. Extrapiramidal symptomathology become chronical and progressive and its development is partially independent from the basic liver complaint. We report one case of "acquired hepatocerebral degeneration" whose clinical features lead us to advance a pathogenetic hypothesis on the role played by neurotransmitters in this syndrome.