Spastic paraparesis associated with advanced liver cirrhosis: a condition obscure in terms of treatment and prognosis

Hepatic myelopathy or spastic paraparesis of liver disease is an insidious onset condition with pure motor spastic paraparesis without sensory, bladder or bowel involvement in patients with chronic liver disease, in which the neurological dysfunction cannot be explained by other causes. It is a rare...

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Bibliographic Details
Published in:BMJ case reports 2020-06, Vol.13 (6), p.e235090
Main Authors: Kaur, Jaspreet, Jesrani, Gautam, Gupta, Monica, Lehl, Sarabmeet Singh
Format: Article
Language:English
Subjects:
Abdomen
Adult
alcoholic liver disease
Ammonia - blood
Ascites
Case reports
cirrhosis
Diagnosis, Differential
Disease Progression
Edema
Flow velocity
Hepatic Encephalopathy - diagnosis
Hepatic Encephalopathy - etiology
Hepatic Encephalopathy - physiopathology
Hepatic Encephalopathy - therapy
Hepatitis
Humans
Hypertension
Liver cirrhosis
Liver Cirrhosis, Alcoholic - complications
Liver Cirrhosis, Alcoholic - diagnosis
Liver diseases
Male
Medical prognosis
Neurologic Examination - methods
Paraparesis, Spastic - diagnosis
Paraparesis, Spastic - etiology
Paraparesis, Spastic - physiopathology
Paraparesis, Spastic - therapy
Patient Care Management - methods
Patients
Prognosis
Proteins
Reminder of Important Clinical Lesson
Serology
Spasticity
Spinal cord
Spinal Cord Diseases - diagnosis
Spinal Cord Diseases - etiology
Treatment Outcome
Citations: Items that this one cites
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Description
Summary:Hepatic myelopathy or spastic paraparesis of liver disease is an insidious onset condition with pure motor spastic paraparesis without sensory, bladder or bowel involvement in patients with chronic liver disease, in which the neurological dysfunction cannot be explained by other causes. It is a rare, relentlessly progressive and mostly irreversible neurological complication resulting from portosystemic shunts occurring spontaneously, created surgically or due to ‘functional shunting’. In some cases, no evidence of shunting is elicitable due to difficulty in locating the hidden collaterals. We report this rare case of a 33-year-old man with chronic liver disease presenting with spastic paraparesis after 11 months of resolution of an episode of hepatic encephalopathy.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-235090