| [ Summary ] |
Minimal hepatic encephalopathy (MHE) is associated with impaired driving skills and a significantly higher risk of motor vehicle crashes, which is an increasing social problem in the world. In Japan, the neuropsychiatric (NP) test is a diagnostic modality now widely available for the diagnosis of MHE. In our prospective study, MHE was noted in 37.5 % of patients diagnosed with cirrhosis who underwent the NP test. MHE is a known risk factor for overt hepatic encephalopathy (OHE), a serious type of hepatic encephalopathy that develops in more than 50 % of patients with MHE within 3 years. Transition to OHE is associated with poor prognosis, overall decline in liver function and shorter life expectancy. Oral supplementation with L‒carnitine demonstrated amelioration of MHE in 45.8 % of patients diagnosed with this condition. The MHE‒amelioration rate following L‒carnitine supplementation was better in the group that had a higher serum level of taurine before L‒carnitine supplementation than in that with a lower serum level of taurine before L‒carnitine was given. Oral supplementation with L‒carnitine, by suppressing the transition from MHE to OHE, could improve the prognosis of cirrhotic patients with MHE. |