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KMID : 0960920020010010048
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Dementia and Neurocognitive Disorders
2002 Volume.1 No. 1 p.48 ~ p.52
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A Case of Hepatic Encephalopathy Presenting Bradykinesia and Abulia
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Moon So-Young
Jeong Yong
Kang Sue-Jin
Chin Ju-Hee
Na Duk-Lyul
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Abstract
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We report a 70-year-old woman who, without a prior history of liver disease, presented abulia and bradykinesia as the initial symptoms of hepatic encephalopathy(HE). Neurological examination showed bilateral extensor plantar responses in addition to mild parkinsonian features. On neuropsychological tests, she was impaired at the attention, visuospatial fuction, memory, and frontal lobe function. Laboratory tests were remarkable for increased AST and ammonia, and positive lgG HbcAb. The results of ultrasonograph of the liver were consisted with chronic lover disease. Brain T1-weighted MRI revealed a high signal intensity in bilateral basal ganglia. Brain PET showed diffuse cerebral hypometabolism. After treatment with oral lactulose, the above symptoms remained improved for the next 6-month of follow-up. From this case, we learned that hepatic encephalopathy could be a reversible of dementia plus parkinsonism even in patients without a prior history of chronic liver disease.
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KEYWORD
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Hepatic encephalopathy, Abulia, Bradykinesia, Chronic liver disease, Parkinsonism, Dementia
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