Skip to main content

Dynamic posturography findings among patients with liver cirrhosis in Egypt

Abstract

Background

Liver cirrhosis is a condition that destroys the normal function of the liver, leading to hepatic encephalopathy, which is associated with impairment in postural control and disturbance in balance.

Aim of the study

The aim of this study was to detect the disturbances in balance and postural control because of hepatic encephalopathy as a result of liver cirrhosis using dynamic posturography.

Participants and methods

Individuals were divided into two groups: 45 patients with liver cirrhosis and 45 controls. Both groups underwent dynamic posturography to evaluate balance control, number connection test-type A, line tracing test, and serum ammonia (NH3) level to assess encephalopathy.

Results

Dynamic posturography findings were significantly weaker in patients with liver cirrhosis than in the controls. They were also weaker in patients with high NH3 than in patients with low NH3. There were significant negative correlations between dynamic posturography findings and number connection test-type A, line tracing test, and NH3 levels.

Conclusion

Hepatic encephalopathy because if liver cirrhosis affects balance control and the degree of affection is related to the degree of encephalopathy.

References

  1. Sorrell MF, Belongia EA, Costa J, Gareen IF, Grem JL, Inadomi JM, et al. National Institutes of Health Consensus Development Conference Statement: management of hepatitis B. Ann Intern Med 2009; 150:104–110.

    Article  Google Scholar 

  2. Abdel-wahab MF, Zakaria S, Kamel M, Abdell-Khaliq MK, Mabrouk MA, Salama H, et al. High seroprevalence of hepatitis C infection among risk groups in Egypt. Am J Trop Med Hyg 1994; 51:563–567.

    Article  CAS  Google Scholar 

  3. Ong JP, Mullen KD. Hepatic encephalopathy. Eur J Gastroenterol Hepatol 2001; 13:325–334.

    Article  CAS  Google Scholar 

  4. Groeneweg MQ, Uero JC, De Bruijn I, Hartmann IJ, Essinkbot ML, Hop WC, et al. Subclinical hepatic encephalaopathy impairs daily functioning. Hepa-tology 1998; 28:45–49.

    CAS  Google Scholar 

  5. Mei-Yun L, Chia-Ling C, Yu-Cheng P, Chau-Peng L, Yiu-Chung LM, et al. Comparison of the static and dynamic balance performance in young, middle-aged, and elderly healthy people. Chang Gung Med J 2009; 32:297–304.

    Google Scholar 

  6. Schmid M, Mittermaier C, Voller B, Fialka-Moser V, Gangl A, Peck-Radosavljevic M, et al. Postural control in patients with liver cirrhosis: a posturographic study. Eur J Gastroenterol Hepatol 2009; 21:915–922.

    Article  Google Scholar 

  7. Sharma P, Sarmasa BC, Tyagi P, Kumar M, Sarin SK. Neuropsychological impairment in severe acute viral hepatitis is due to minimal hepatic en-cephalopathy. Liver Int 2009; 29:260–264.

    Article  CAS  Google Scholar 

  8. Black F. What can posturography tell us about vestibular function? Ann N Y Acad Sci 2001; 942:446–464.

    Article  CAS  Google Scholar 

  9. Karin W, Norbrbert R, Harmtmut H, Michael PM. The number connection tests A and B: interindividual variability and use for the assessment of early hepatic encephalopathy. J Hepatol 1998; 28:646–653.

    Google Scholar 

  10. Butz M, Timmerman L, Braun M, Groiss SJ, Wojtecki L, Ostrowski S, et al. Motor impairment in liver cirrhosis without and with minimal hepatic en-cephalopathy. Acta Neurol Scand 2010; 122:27–35.

    Article  CAS  Google Scholar 

  11. Monfort P, Cauli O, Montoliu C, Rodrigo R, Lansola M, Piedrafita B, et al. Mechanisms of cognitive alterations in hyperammonemia and hepatic en-cephalopathy: therapeutically implications. Neurochem Int 2009; 55: 106–112.

    Article  CAS  Google Scholar 

  12. Monsell EM, Furman JM, Herdman SJ, Konrad HR, Shepard NT. Computerized dynamic platform posturography. Otolaryngol Head Neck Surg 1997; 117:394–398.

    Article  CAS  Google Scholar 

  13. Zeegen R, Drinkwater JE, Dawson AM. Methods of measuring cerebral dysfunction in patients with liver disease. Br Med J 1970; 2:633–636.

    Article  CAS  Google Scholar 

  14. Quero JC, Hartmann IJ, Meulsteeul J, Hop WC, Schalm SW, et al. The diagnosis of subclinical hepatic encephalopathy in patients with cirrhosis using neuropsychological tests and automated electroencephalogram analysis. Hepatology 1996; 24:556–560.

    Article  CAS  Google Scholar 

  15. Loguercio C, Delevecchio-Blanco C, Coltorti M. Psycho-metric tests and ‘latent’ portal-systemic encephalopathy. Br J Clin Pract 1984; 38: 407–411.

    CAS  PubMed  Google Scholar 

  16. Sood GK, Sarin S, Mahaptra J, Broor SL. Comparative efficacy of psychometric tests in detection of subclinical hepatic encephalopathy in nonalcoholic cirrhotics: search for a rational approach. Am J Gastroenterol 1989; 84:156–159.

    CAS  PubMed  Google Scholar 

  17. Marchesini G, Zoli M, Dondi C, Cecchini L, Angiolini A, Bianchi FB, et al. Prevalence of subclinical hepatic encephalopathy in cirrhotics and relationship to plasma amino acid imbalance. Dig Dis Sci 1980; 25: 763–768.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Wael M. Aref.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Aref, W.M., Hosni, N.A., Naguib, M. et al. Dynamic posturography findings among patients with liver cirrhosis in Egypt. Egypt J Intern Med 24, 100–104 (2012). https://doi.org/10.7123/01.EJIM.0000422797.51953.a7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.7123/01.EJIM.0000422797.51953.a7

Keywords

  • dynamic posturography
  • hepatic encephalopathy
  • liver cirrhosis