DOI: 10.36347/sjams.2016.v04i11.009

Pages: 3900-3902

Minimal hepatic encephalopathy (MHE) is a condition in which patients with cirrhosis of liver that has normal mental and neurological status on standard clinical examination , exhibit a number of neuropsychiatric and neurophysiological defects. It has no recognizable clinical symptoms but have mild cognitive and psychomotor deficits which cannot be diagnosed by the clinical examination. PHES (Psychometric Hepatic encephalopathy Scores) is a useful bedside test for detecting patients with MHE. Early diagnosis and treatment has a favourable outcome. The study was a prospective observational study, conducted in all consecutive cirrhotic patients without overt HE (evaluated by the West–Haven criteria) the clinical HE staging scale admitted to the Medicine department PHES was determined for thirty cirrhosis patients and compared with thirty age and education matched controls. Cases who had abnormal PHES (> two standard deviation from the normal ) were treated with lactulose and follow up PHES was done after 15 days. Among thirty cases, PHES was abnormal in 14 (46.66%) and hence diagnosed to have MHE. Among 14 , 2 of them were lost for follow up (cause not known), 12 of them had improvement in PHES .PHES is a useful bedside test for detecting patients with MHE. A significant proportion of patients with liver cirrhosis suffer from MHE. Early diagnosis and treatment has a favourable outcome.