Markers of reversible hepatic encephalopathy
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To the Editor: Pujol et al.1 reported the simultaneous use of T1-weighted MRI and magnetic resonance spectroscopy (MRS) in a series of patients with chronic liver failure. Both diagnostic modalities recently were independently identified as markers of hepatocerebral disease in patients with chronic liver failure.2-4 However, currently their nature and clinical relevance are obscure.
Several lines of evidence indicate that MRI hyperintensity in the globus pallidus is caused by manganese accumulation in the central nervous system: 1) clinicopathologic studies revealed elevated manganese concentrations in the areas of abnormal hyperresonance5,6; 2) MRI findings resemble those found in manganese intoxication,7 …
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Expedited PublicationNeurospectroscopic alterations and globus pallidus hyperintensity as related magnetic resonance markers of reversible hepatic encephalopathyJ. Pujol, J. Kulisevsky, A. Moreno et al.Neurology, December 01, 1996