Hepatic Encephalopathy

  • Karin Weissenborn


Hepatic encephalopathy (HE) is a neuropsychiatric syndrome associated with severe, acute and chronic liver failure. According to the recommendations of a working party (Ferenci et al., 2002) held at the 4th World Congress of Gastroenterology in Vienna in 1998, 3 types of HE should be differentiated, on principle:


Hepatic Encephalopathy Brain Edema Cerebral Perfusion Pressure Acute Liver Failure Ammonia Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Aggarwal, S., Kang, Y., DeWolf, A., Scott, V., Martin, M., Policare, R. 1993. Transcranial doppler monitoring of cerebral blood flow velocity during liver transplantation. Transplant Proc 25 (2): 1799–1800PubMedGoogle Scholar
  2. Amodio, P., Gatta, A. 2005. Neurophysiological investigation of hepatic encephalopathy. Metabol Brain Dis 20 (4): 369–379CrossRefGoogle Scholar
  3. Amodio, P., Marchetti, P., Del Piccolo, F., de Tourtchaninoff, M., Varghese, P., Zuliani, C., Campo, G., Gatta, A., Guerit, J.M. 1999. Spectral versus visual EEG analysis in mild hepatic encephalopathy. Clin Neurophysiol 110: 1334–1344PubMedCrossRefGoogle Scholar
  4. Atterbury, C.E., Maddrey, W., Conn, H.O. 1978. Neomycin-sorbitol and lactulose in the treatment of acute portal-systemic encephalopathy. A controlled, double-blind clinical trial. Am J Dig Dis. 23: 398–406PubMedCrossRefGoogle Scholar
  5. Bajaj, J.S., Etemadian, A., Hafeezullah, M., Saeian, K. 2007a. Testing for minimal hepatic encephalopathy in the United States: An AASLD survey. Hepatology 45 (3): 833–834CrossRefGoogle Scholar
  6. Bajaj, J.S., Saeian, K., Verber, M.D., Hischke, D., Hoffmann, R.G., Franco, J., Varma, R.R., Rao, S.M. 2007b. Inhibitory control test is a simple method to diagnose minimal hepatic encephalopathy and predict development of overt hepatic encephalopathy. Am J Gastroenterol 102: 1–7CrossRefGoogle Scholar
  7. Bhatia, V., Batra, Y., Acharya, S.K. 2004. Prophylactic phenytoin does not improve cerebral edema or survival in acute liver failure — a controlled clinical trial. J Hepatology 41: 89–96CrossRefGoogle Scholar
  8. Bhatia, V., Singh, R., Acharya, S.K. 2006. Predictive value of arterial ammonia for complications and outcome in acute liver failure. GUT 55 (1): 98–104PubMedCrossRefGoogle Scholar
  9. Bianchi, G.P., Marchesini, G., Fabbri, A., Rondelli, A., Bugianesi, E., Zoli, M., Pisi, E. 1993. Vegetable versus animal protein diet in cirrhotic patients with chronic encephalopathy: A randomized cross-over comparison. J Intern Med 233: 385–392PubMedCrossRefGoogle Scholar
  10. Blei, A.T., Olafsson, S., Webster, S., Levy, R. 1993. Complications of intracranial pressure monitoring in fulminant hepatic failure. Lancet 341: 157–158PubMedCrossRefGoogle Scholar
  11. Bustamante, J., Rimola, A., Ventura, P.J., Navasa, M., Cirera, I., Reggiardo, V., Rodes, J. 1999. Prognostic significance of hepatic encephalopathy in patients with cirrhosis. J Hepatol 30: 890–895PubMedCrossRefGoogle Scholar
  12. Cadranel, J.F., Lebiez, E., Di Martino, V., Bernard, B., El Koury, S., Tourbah, A., Pidoux, B., Valla, D., Opolon, P. 2001. Focal neurological signs in hepatic encephalopathy in cirrhotic patients: An underestimated entity. Am J Gastroenterol 96: 515–518PubMedCrossRefGoogle Scholar
  13. Campellone, J.V., Lacomis, D., Giuliani, M.J., Kroboth, F.J. 1996. Hepatic myelopathy. Case report with review of the literature. Clin Neurol Neurosurg 98: 242–246PubMedCrossRefGoogle Scholar
  14. Canalese, J., Gimson, A.E., Davis, C., Mellon, P.J., Davis, M., Williams, R. 1982. Controlled trial of dexamethasone and mannitol for the cerebral edema of fulminant hepatic failure. Gut 23: 625–629PubMedCrossRefGoogle Scholar
  15. Cordoba, J., Cabrera, J., Lataif, L., Penev, P., Zee, P., Blei, A.T. 1998. High prevalence of sleep disturbances in cirrhosis. Hepatology 27: 339–345PubMedCrossRefGoogle Scholar
  16. Cordoba, J., Lopez-Hellin, J., Planas, M., Sabin, P., Sanpedro, F., Castro, F., Esteban, R., Guardia, J. 2004. Normal protein diet for episodic hepatic encephalopathy: Results of a randomized study. J Hepatol 41: 38–43.PubMedCrossRefGoogle Scholar
  17. Davies, M.G., Rowan, M.J., Feely, J. 1991. EEG and event related potentials in hepatic encephalopathy. Metab Brain Dis 1991; 6: 175–186.CrossRefGoogle Scholar
  18. Ellis, A.J., Wendon, J.A., Williams, R. 2000. Subclinical seizure activity and prophylactic phenytoin infusion in acute liver failure: A controlled clinical trial. Hepatology 32: 536–541PubMedCrossRefGoogle Scholar
  19. Ferenci, P., Lockwood, A.H., Mullen, K., Tarter, R., Weissenborn, K., Blei, A.T. 2002. Hepatic encephalopathy — definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congress of Gastroenterology. Vienna 1998; Hepatology 35(3): 716–721Google Scholar
  20. Gitlin, N., Lewis, D.C., Hinkley, L. 1986. The diagnosis and prevalence of subclinical hepatic encephalopathy in apparently healthy ambulant non-shunted patients with cirrhosis. J Hepatol 3: 75–82PubMedCrossRefGoogle Scholar
  21. Groeneweg, M., Quero, J.C., De Bruijn, I., Hartmann, I.J., Essink-bot, M.L., Hop, W.C., Schalm, S.W. 1998. Subclinical hepatic encephalopathy impairs daily functioning. Hepatology 28: 45–49PubMedCrossRefGoogle Scholar
  22. Hartmann, I.J.C., Groeneweg, M., Quero, J.C., Beijeman, S.L., de Man, R.A., Hop, W.C., Schalm, S.W. 2000. The prognostic significance of subclinical hepatic encephalopathy. Am J Gastroenterol 2000; 95: 2029–2034CrossRefGoogle Scholar
  23. Homburg, A.M., Jacobsen, M., Enevoldsen, E. 1993. Transcranial doppler recordings in raised intracranial pressure. Acta Neurol Scand 87: 488–493PubMedCrossRefGoogle Scholar
  24. Hui, A.Y., Chan, H.L., Leung, N.W., Hung, L.C., Chan, F.K., Sung, J.J. 2002. Survival and prognostic indicators in patients with hepatitis B virus-related cirrhosis after onset of hepatic decompensation. J Clin Gastroenterol 34(5): 569–572PubMedCrossRefGoogle Scholar
  25. Jalan, R., Olde Damink, S.W., Deutz, N.E., Hayes, P.C., Lee, A. 2004. Moderate hypothermia in patients with acute liver failure and uncontrolled intracranial hypertension. Gastroenterology 127: 1338–1346PubMedCrossRefGoogle Scholar
  26. Kircheis, G., Nilius, R., Held, C., Berndt, H., Buchner, M., Görtelmeyer, R., Hendricks, R., Kruger, B., Kuklinski, B., Meister, H., Otto, H.J., Rink, C., Rosch, W., Stauch, S. 1997. Therapeutic efficacy of L-Ornithine-L-Aspartate infusions in patients With cirrhosis and hepatic encephalopathy: Results of a placebo-controlled, double-blind study. Hepatology 25: 1351–1360PubMedCrossRefGoogle Scholar
  27. Kircheis, G., Wettstein, M., Timmermann, L., Schnitzler, A., Haussinger, D. 2002. Critical flicker frequency for quantification of low-grade hepatic encephalopathy. Hepatology. 35: 357–366.PubMedCrossRefGoogle Scholar
  28. Krieger, S., Jauss, M., Jansen, O., Theilmann, L., Geissler, M., Krieger, D. 1996. Neuropsychiatric profile and hyperintense globus pallidus on T1-weighted magnetic resonance images in liver cirrhosis. Gastroenterology 111: 147–155PubMedCrossRefGoogle Scholar
  29. Kril, J.J., Butterworth, R.F. 1997. Diencephalic and cerebellar pathology in alcoholic and non-alcoholic patients with end-stage liver disease. Hepatology 26 (4): 837–841PubMedCrossRefGoogle Scholar
  30. Kullmann, F., Hollerbach, S., Holstege, A., Schölmerich, J. 1995. Subclinical hepatic encephalopathy: The diagnostic value of evoked potentials. J Hepatol 22: 101–110PubMedCrossRefGoogle Scholar
  31. Larsen, F.S., Ejlersen, E., Hansen, B.A., Knudsen, G.M., Tygstrup, N., Secher, N.H. 1995a. Functional loss of cerebral blood flow autoregulation in patients with fulminant hepatic failure. J Hepatol 23: 212–217CrossRefGoogle Scholar
  32. Larsen, F.S., Pott, F., Hansen, B.A., Ejlersen, E., Knudsen, G.M., Clemmesen, J.D., Secher, N.H. 1995b. Transcranial doppler sonography may predict brain death in patients with fulminant hepatic failure. Transpl Proc 27 (6): 3510–3511Google Scholar
  33. Leevy, C.B., Phillips, J.A. 2007. Hospitalizations during the use of rifaximin versus lactulose for the treatment of hepatic encephalopathy. Dig Dis Sci; 52: 737–741PubMedCrossRefGoogle Scholar
  34. Lockwood, A.H. 2000. “What’s in a name?” Improving the care of cirrhotics. J Hepatol 32: 859–861PubMedCrossRefGoogle Scholar
  35. Lockwood, A.H., Butterworth, R.F., Weissenborn, K. 1997. An image of the brain in liver disease. Curr Opin Neurol 10(6): 525–533PubMedCrossRefGoogle Scholar
  36. Lockwood, A.H., Murphy, B.W., Donnelly, K.Z., Mahl, T.C., Perini, S. 1993. Positron-emission tomographic localization of abnormalities of brain metabolism in patients with minimal hepatic encephalopathy. Hepatology 18 (5): 1061–1068PubMedCrossRefGoogle Scholar
  37. Lockwood, A.H., Weissenborn, K., Bokemeyer, M., Tietge, U., Burchert, W. 2002. Correlations between cerebral glucose metabolism and neuropsychological test performance in non-alcoholic cirrhotics. Metab Brain Dis 17(1): 29–40PubMedCrossRefGoogle Scholar
  38. Marchesini, G., Bianchi, G., Merli, M., Amodio, P., Panella, C., Loguercio, C., Rossi Fanelli, F., Abbiati, R., and Italian BCAA Study Group. 2003. Nutritional supplementation with branched-chain amino acids in advanced cirrhosis: A double-blind, randomized trial. Gastroenterology 124: 1792–1801PubMedCrossRefGoogle Scholar
  39. Marchesini, G., Fabbri, A., Bianchi, G., Brizi, M., Zoli, M. 1996. Zinc supplementation and amino-acid-nitrogen metabolism in patients with advanced cirrhosis. Hepatology 23: 1084–1092PubMedCrossRefGoogle Scholar
  40. Mas, A., Rodes, J., Sunyer, L., Rodrigo, L., Planas, R., Vargas, V., Castells, L., Rodriguez-Martinez, D., Fernandez-Rodriguez, C., Coll, I., Pardo, A.;, Spanish Association for the study of the Liver Hepatic Encephalopathy Cooperative Group. 2003. Comparison of rifaximin and lactitol in the treatment of acute hepatic encephalopathy: Results of a randomized, double-blind, double-dummy, controlled clinical trial. J Hepatol. 38: 51–58.PubMedCrossRefGoogle Scholar
  41. Montagnese, S., Amodio, P., Morgan, M.Y. 2004. Methods for diagnosing hepatic encephalopathy in patients with cirrhosis: A multidimensional approach. Metab Brain Dis 19: 281–312PubMedCrossRefGoogle Scholar
  42. Montagnese, S., Jackson, C., Morgan, M.Y. 2007. Spatio-temporal decomposition of the electroencephalogram in patients with cirrhosis. J Hepatol 46: 447–458PubMedCrossRefGoogle Scholar
  43. Morgan, M.Y., Alonso, M., Stanger, L.C. 1989. Lactitol and lactulose for the treatment of subclinical hepatic encephalopathy in cirrhotic patients. J Hepatol 8: 208–217PubMedCrossRefGoogle Scholar
  44. Morgan, M.Y., Hawley, K.E. 1987. Lactitol versus lactulose in the treatment of acute hepatic encephalopathy in cirrhotic patients: a double-blind, randomized trial. Hepatology 7(6): 1278–1284PubMedCrossRefGoogle Scholar
  45. Munoz, S.J. 1993. Difficult management problems in fulminant hepatic failure. Semin Liver Disease 13: 395–413CrossRefGoogle Scholar
  46. Murphy, N., Auzinger, G., Bernal, W., Wendon, J. 2004. The effect of hypertonic sodium chloride on intracranial pressure in patients with acute liver failure. Hepatology 39: 464–470PubMedCrossRefGoogle Scholar
  47. Muto, Y., Sato, S., Watanabe, A., Moriwaki, H., Suzuki, K., Kato, A., Kato, M., Nakamura, T., Higuchi, K., Nishiguchi, S., Kumada, H., Ohashi, Y.;, for the Long-Term-Survival Study (LOTUS) Group. 2005. Effects of oral branched-chain amino acid granules on event-free survival in patients with liver cirrhosis. Clin Gastroenterol Hepatol. 3: 705–713.PubMedCrossRefGoogle Scholar
  48. O’Grady, J.G., Schalm, S.W., Williams, R. 1993. Acute liver failure: Redefining the syndromes. Lancet 342: 273–275PubMedCrossRefGoogle Scholar
  49. Ostapowicz, G.A., Fontana, R.J., Schiodt, F.V., Larson, A., Davern, T.J., Han, S.H., McCashland, T.M., Shakil, A.O., Hay, J.E., Hynan, L., Crippin, J.S., Blei, A.T., Samuel, G., Reisch, J., Lee, W.M.;, U.S. Acute Liver Failure Study Group. 2002. Results of a prospective study of acute liver failure at 17 tertiary care centers in the United States. Ann Intern Med 137: 947–954PubMedGoogle Scholar
  50. Parsons-Smith, B.G., Summerskill, W.H.J., Dawson, A.M., Sherlock, S. 1957. The electroencephalograph in liver disease. Lancet ii: 867–871CrossRefGoogle Scholar
  51. Penin, H. 1967. Über den diagnostischen Wert des Hirnstrombildes bei der hepato-portalen Encephalopathie. Fortschr Neurol Psychiatr 35 (4): 174–234Google Scholar
  52. Polson, J., Lee, W.M. 2005. AASLD position paper: The management of acute liver failure. Hepatology 41(5): 1179–1197PubMedCrossRefGoogle Scholar
  53. Poo, J.L., Gongora, J., Sanchez-Avila, F., Aguilar-Castillo, S., Garcia-Ramos, G., Fernandez-Zertuche, M., Rodriguez-Fragoso, L., Uribe, M. 2006. Efficacy of oral L-ornithine-L-aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy. Results of a randomized, lactulose-controlled study. Ann Hepatol 5(4): 281–288PubMedGoogle Scholar
  54. Powell, E.E., Pender, M.P., Chalk, J.B., Parkin, P.J., Strong, R., Lynch, S., Kerlin, P., Cooksley, W.G., Cheng, W., Powell, L.W. 1990. Improvement in chronic hepatocerebral degeneration following liver transplantation. Gastroenterology 98: 1079–1082PubMedCrossRefGoogle Scholar
  55. Prasad, S., Dhiman, R.K., Duseja, A., Chawla, Y.K., Sharma, A., Agarwal, R. 2007. Lactulose improves cognitive functions and health-related quality of life in patients with cirrhosis who have minimal hepatic encephalopathy. Hepatology 45: 549–559PubMedCrossRefGoogle Scholar
  56. Quadri, A.M., Ogunwale, B.O., Mullen, K.D. 2007. Can we ignore minimal hepatic encephalopathy any longer. Hepatology 45: 547–548CrossRefGoogle Scholar
  57. Raghavan, M., Marik, P.E. 2006. Therapy of intracranial hypertension in patients with fulminant hepatic failure. Neurocrit Care 4: 179–189PubMedCrossRefGoogle Scholar
  58. Riggio, O., Ariosto, F., Merli, M., Caschera, M., Zullo, A., Balducci, G., Ziparo, V., Pedretti, G., Fiaccodori, F., Bottari, E. et al. 1991. Short-term oral zinc supplementation does not improve chronic hepatic encephalopathy: results of a double-blind crossover trial. Dig Dis Sci 36: 1204–1208PubMedCrossRefGoogle Scholar
  59. Rinella, M.E., Sanyal, A. 2006. Intensive management of hepatic failure. Sem Respiratory Crit Care Med 27(3): 241–261CrossRefGoogle Scholar
  60. Romero-Gomez, M., Cordoba, J., Jover, R., Del Olmo, J.A., Ramirez, M., Rey, R., de Madaria, E., Montoliu, C., Nunez, D., Flavia, M., Company, L., Rodrigo, J.M., Felipo, V. 2007. Value of the critical flicker frequency in patients with minimal hepatic encephalopathy. Hepatology 45(4): 879–885PubMedCrossRefGoogle Scholar
  61. Sass, D.A., Shakil, A.O. 2005. Fulminant hepatic failure. Liver Transplantation 11(6): 594–605PubMedCrossRefGoogle Scholar
  62. Schnittger, C., Weissenborn, K., Böker, K., Kolbe, H., Dengler, R., Manns, M.P. 1997. Continuous noninvasive cerebral perfusion monitoring in fulminant hepatic failure and brain oedema. In Advances in Hepatic Encephalopathy & Metabolism in Liver Disease. eds C. Record and H. Al Mardini (eds.)., pp. 515–519. New Castle upon Tyne: Medical Faculty of the University of Newcastle upon TyneGoogle Scholar
  63. Schomerus, H., Hamster, W. 1998. Neuropsychological aspects of portal-systemic encephalopathy. Metab Brain Dis 13(4): 361–377PubMedCrossRefGoogle Scholar
  64. Schomerus, H., Hamster, W. 2001. Quality of life in cirrhotics with minimal hepatic encephalopathy. Metab Brain 16 (1/2): 37–42CrossRefGoogle Scholar
  65. Schomerus, H., Hamster, W., Blunck, H., Reinhard, U., Mayer, K., Dolle, W. 1981. Latent portasystemic encephalopathy: I. Nature of cerebral functional defects and their effect on fitness to drive. Dig Dis Sci 26: 622–630PubMedCrossRefGoogle Scholar
  66. Schomerus, H., Schreiegg, J. 1993. Prevalence of latent portasystemic encephalopathy in an unselected population of patients with liver cirrhosis in general practice. Z Gastroenterol 31: 231–234PubMedGoogle Scholar
  67. Schomerus, H., Weissenborn, K., Hamster, W., Rueckert, N., Hecker, H. 1999. PSE-syndrom-test. Psychodiagnostisches Verfahren zur quantitativen Erfassung der (minimalen) portosystemischen Enzephalopathie. Frankfurt: Swets Test Services.Google Scholar
  68. Shami, V.M., Caldwell, S.H., Hespenheide, E.E., Arseneau, K.O., Blickston, S.J., Macik, B.G. 2003. Recombinant activated factor VII for coagulopathy in fulminant hepatic failure compared with conventional therapy. Liver Transpl 9: 138–143PubMedCrossRefGoogle Scholar
  69. Sherlock, S., Summerskill, W.H.J., White, L.P., Phear, E.A. 1954. Portal-systemic encephalopathy. Neurological complications of liver disease. Lancet I: 453–457CrossRefGoogle Scholar
  70. Spahr, L., Butterworth, R.F., Fontaine, S., Bui, L., Therrien, G., Milette, P.C., Lebrun, L.H., Zayed, J., Leblanc, A., Pomier-Layrargues, G. 1996. Increased blood manganese in cirrhotic patients: Relationship to pallidal magnetic resonance signal hyperintensity and neurological symptoms. Hepatology 1996; 24: 1116–1120CrossRefGoogle Scholar
  71. Srivastava, A., Mehta, R., Rothke, S.P., Rademaker, A.W., Blei, A.T. 1994. Fitness to drive in patients with cirrhosis and portal systemic shunting: A pilot study evaluating driving performance. J Hepatol 21: 1023–1028PubMedCrossRefGoogle Scholar
  72. Stauch, S., Kircheis, G., Adler, G., Beckh, K., Ditschuneit, H., Görtelmeyer, R., Hendricks, R., Heuser, A., Karoff, C., Malfertheiner, P., Mayer, D., Rosch, W., Steffens, J. 1998. Oral L-ornithine-L-aspartate therapy of chronic hepatic encephalopathy: Results of a placebo-controlled double-blind study. J Hepatol 28: 856–864PubMedCrossRefGoogle Scholar
  73. Tofteng, F., Larsen, F.S. 2004. The effect of indomethacin on intracranial pressure, cerebral perfusion and extracellular lactate and glutamate concentrations in patients with fulminant hepatic failure. J Cereb Blood Flow Metab 24: 798–804PubMedCrossRefGoogle Scholar
  74. Van der Rijt, C.D.C., Schalm, S., De Groot, G.H., De Vlieger, M. 1990. Objective measurement of hepatic encephalopathy by means of automated EEG analysis. Electroencephalogr Clin Neurophysiol 75: 289–295CrossRefGoogle Scholar
  75. Van der Rijt, K., Schalm, S.W., Schat, H., Foeken, K., De Jong, G. 1991. Overt hepatic encephalopathy precipitated by zinc deficiency. Gastroenterology 100: 114–118Google Scholar
  76. Vaquero, J., Fontana, R.J., Larson, A.M., Bass, N.M.T., Davern, T.J., Shakil, A.O., Han, S., Harrison, M.E., Stravitz, T.R., Munoz, S., Brown, R., Lee, W.M., Blei, A.T. 2005. Complications and use of intracranial pressure monitoring in patients with acute liver failure and severe encephalopathy. Liver Transpl 12: 1581–1589CrossRefGoogle Scholar
  77. Victor, M., Adams, R.D., Cole, M. 1965. The acquired (non-Wilsonina) type of chronic hepatocerebral degeneration. Medicine (Baltimore) 44: 345–394CrossRefGoogle Scholar
  78. Watanabe, A., Tuchida, T., Yata, Y., Kuwabara, J. 1995. Evaluation of neuropsychological function in patients with liver cirrhosis with special reference to their driving ability. Metab Brain Dis. 10: 239–248PubMedCrossRefGoogle Scholar
  79. Wein, C., Koch, H., Popp, B., Oehler, G., Schauder, P. 2004. Minimal hepatic encephalopathy impairs fitness to drive. Hepatology 39: 739–745PubMedCrossRefGoogle Scholar
  80. Weissenborn, K. 1991. Neurophysiological methods in the diagnosis of Eearly hepatic encephalopathy. In Progress in Hepatic Encephalopathy and Metabolic Nitrogen Exchange. Bengtsson F, Jeppsson B, Almdal T, Vilstrup H (eds.)., pp 27–39. Boca Raton: CRC PressGoogle Scholar
  81. Weissenborn, K., Ennen, J.C., Schomerus, H., Ruckert, N., Hecker, H. 2001. Neuropsychological characterization of hepatic encephalopathy. J Hepatol. 34: 768–773.PubMedCrossRefGoogle Scholar
  82. Weissenborn, K., Scholz, M., Hinrichs, H., Wiltfang, J., Schmidt, F.W., Künkel, H. 1990. Neurophysiological assessment of early hepatic encephalopathy. Electroencephalogr Clin Neurophysiol 1990; 75: 289–295CrossRefGoogle Scholar
  83. Weissenborn, K., Tietge, U.J., Bokemeyer, M., Mohammadi, B., Bode, U., Manns, M.P., Caselitz, M. 2003. Liver transplantation improves hepatic myelopathy: Evidence by three cases. Gastroenterology. 2003; 124: 346–351CrossRefGoogle Scholar
  84. White, M.L., Zhang, Y., Andrew, L.G., Hadley, W.L. 2005. MR imaging with diffusion-weighted imaging in acute and chronic wernicke encephalopathy. AJNR 26: 2306–2310PubMedGoogle Scholar
  85. Zhong, C., Jin, L., Fei, G. 2005. MR imaging of nonalcoholic wernicke encephalopathy: A follow-up study. AJNR 26: 2301–2305PubMedGoogle Scholar

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© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Karin Weissenborn
    • 1
  1. 1.Department of NeurologyMedical School of HannoverHannoverGermany

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