Dyskinesia-hepatocerebral degeneration.Misericordia Hospital

A 58 years old man with hepatic insufficiency (presumably alcoholic) and four episodes of acute hepatic encephalopathy in the last year, developed dyskinesia and dysarthria in the last internation.
Neuropsychiatrics manifestations were prominent while he was encephalopatic but with minimal expression when he developed dyskinesias.

Acquired hepatocerebral degeneration features are entirely different from acute hepatic encephalopathy episodes.1
Neurological manifestations may combine: chorea, dysarthria, postural and intentional tremor , orofacial or generalized dyskinesias, somnolence, and very rarely, transverse myelitis.

Choreic movements, typically present as prominent orofacial-buccal and lingual are the most frequent observed while resting tremor and dystonia are less frequent. Neuropsychiatric manifestations are minimal.
T1-weighted magnetic resonance imaging scan (not performed) may show symmetric high intensity signal lesions in the bilateral globus pallidus and mild cerebral atrophy.
Treatments include haloperidol, transplant surgery, benztropine,Tetrabenazine and
Ropinirole.

1-Pierre R. Burkhard, MD; Jacqueline Delavelle, MD; Renaud Du Pasquier, MD; Laurent Spahr, MD Chronic Parkinsonism Associated With Cirrhosis A Distinct Subset of Acquired Hepatocerebral Degeneration Arch Neurol. 2003;60:521-528.

2- E A Jones,aK Weissenborn Neurology and the liver J Neurol Neurosurg Psychiatry 1997;63:279-293 ( September )

3-Stephanie Thobois, MD, Pierric Giraud, MD,. Pierre Debat, MD, et al. Orofacial Dyskinesias in a Patient with.Primary Biliary Cirrhosis:A Clinicopathological Case Report and Review. Movement Disorders, Vol. 17, No. 2 ,p 415-419- 2002

4-Spiridon Papapetropoulos. Carlos Singer. Management of the Extrapyramidal Syndrome in Chronic Acquired Hepatocerebral Degeneration (CAHD) Movement Disorders, Vol. 20, No. 8, p-1088- 2005

Category:

Science & Technology

Tags:

• Dyskinesias_Orofacial
• acquired
• hepatocerebral
• degeneration

[rsls101]

Cirrhosis and the Complications are a serious Issue! It's not a Freakshow for your Music Video! Was the Music Really Necessary it's not Funny, especially when you have Family going through the same thing

[cosacov]

@rsls101 : please read with atention the explanation in the video and you will realize that this is an cientifc one.It is serious not for funny It has a bibliographic data. This condition is inusual. to develop without psichiatric alteration. I craint you had misinterpreted it.

[cosacov]

If you want to know more, read please where it say "more information"

[MsSobergirl05]

The music made the video appear to be a joke of some sort......... a very sick joke.

[torrejademono]

musica de fondo? que es esto? falta de respeto.

[rpmsxtreme]

OMG!!! That's Scary is this Because of ammonia buildup toxins to the brain? My dad has encephalopathy caused by liver cirrhosis and I believe he's in stage 2. He gets confused, tremors, forgetfulness and muscle stiffness, is this what's to come??!

[divinacomedias]

"Treatments include haloperidol"

Well very interesting, because the patient is showing symptoms of dyskinesia... which is a secondary effect of Haloperidol.

What is the justification for treatment with Haloperidol?

What proves that dyskinesia and dysarthria is not a result of Haloperidol?

[Gr8vel]

Agree totally with reinasofia84, i can't see what can be gained without hearing his voice. Although Miles Davis is a favourite, i think it's totally out of place here. I was hoping to learn something here.

[ghanimama]

good