1. Berka Open Directory Hepatic Encephalopathy@ (3). Hepatitis@ (91). hepatocerebral encephalopathy@ (3). Hepatolenticular Degeneration@ (13) http://www.berka.com/D.pl/Health/Conditions_and_Diseases/H

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5. 1Up Health > Health Links Directory > Conditions And Diseases: H 7) Hemophilia (25) Hemorrhagic Fevers (51) Hemorrhoids (21) Hepatic Encephalopathy(3) Hepatitis (87) hepatocerebral encephalopathy (3) Hepatolenticular http://www.1uphealth.com/links/conditions-and-diseases-h.html

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6. H Website Results :: Linkspider UK Hepatitis@ (88); hepatocerebral encephalopathy@ (3); HepatolenticularDegeneration@ (14); Hereditary Angioedema@ (5). Hereditary Deafness http://www.linkspider.co.uk/Health/ConditionsandDiseases/H/

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7. CONDITIONS AND DISEASES - Browsing GamePages.com Hepatic Encephalopathy (3). Hepatitis (91). hepatocerebral encephalopathy (3). Hepatolenticular Degeneration (13) http://www.gamepages.com/go/directory/Health/Conditions_and_Diseases/H

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8. Katalog :  : Health : Conditions_and_Diseases : H :  - Netz-Tipp.De Encephalopathy(*); Hepatitis (*); hepatocerebral encephalopathy (*); http://www.netz-tipp.de/kat/Health/Conditions_and_Diseases/H/

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9. Open Directory - Health: Conditions And Diseases: H Hepatitis@ (87); hepatocerebral encephalopathy@ (3); HepatolenticularDegeneration@ (14); Hereditary Angioedema@ (5). Hereditary Deafness http://www.mptdo.com/Health/Conditions_and_Diseases/H/

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10. Directory :: Look.com 7) Hemophilia (29) Hemorrhagic Fevers (51) Hemorrhoids (20) Hepatic Encephalopathy(3) Hepatitis (88) hepatocerebral encephalopathy (3) Hepatolenticular http://www.look.com/searchroute/directorysearch.asp?p=43350

11. Parkinsonism tumor), infections (eg viral encephalitis), exposure to toxins (eg MPTP, carbonmonoxide), metabolic disturbances (eg hepatocerebral encephalopathy), and the http://www.hsph.harvard.edu/Organizations/DDIL/parkins.html

Drug-Induced Parkinsonism: Are Cinnarizine and Flunarizine Implicated? Guilherme L. Werneck Background Parkinsonism PD is generally accepted as a clinicopathological entity that is different from other causes of extrapyramidal signs. However, since there is no accurate biological marker for PD, the differential diagnosis of parkinsonism can be extremely arduous. The reported proportion of cases of parkinsonism induced by drugs varies from 8 to 51%. The relative frequency of drug-induced parkinsonism may be underestimated since drug reactions in older persons may suggest the presence of a new disease or may simply be attributed to the aging process. This misinterpretation is particularly likely when the drug-induced symptoms correlate almost perfectly with those of PD, an illness that occurs more frequently in the elderly. In addition, a global underestimation of adverse drug effects in the elderly is likely, since this group is underrepresented in premarketing clinical trials. The proportion of drug-induced parkinsonism may on the other hand be overestimated if some patients had previous subclinical idiopathic PD, and the onset of the classical symptoms coincided with the use of the incriminated drug. Either underestimation or overestimation can also occur depending on the selection of study patients and the criteria used to establish the putative causal relationship.

12. Privattandvård I Örebro, Tandläkaren Michel Deaibes, Sjukdomslista På Engels Hepatic Encephalopathy. Hepatitis. hepatocerebral encephalopathy. HepatolenticularDegeneration. Hereditary Angioedema. Hereditary DeafnessRetinitis Pigmentosa. http://www26.brinkster.com/privtand/sjuk.htm

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13. Browsing Health Conditions And Diseases H Category Uremic Syndrome Hemophilia Hemorrhagic Fevers Hemorrhoids Hepatic EncephalopathyHepatitis hepatocerebral encephalopathy Hepatolenticular Degeneration http://www.uksprite.com/search/search/Health/Conditions_and_Diseases/H/

14. DINO - Language: Englisch - Health - Conditions And Diseases - H Encephalopathy Dieser Link verweist auf eine HauptKategorie Hepatitis Dieser Linkverweist auf eine Haupt-Kategorie hepatocerebral encephalopathy Dieser Link http://www.dino-online.de/dino_page_5eb30c831041b37311023286c4a3ca2d.html

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17. Hepatocerebral Degeneration mechanism is unknown but there appears to be a close relationship between the acutetransient form of hepatic encephalopathy and the hepatocerebral syndrome. http://www.neuro.nwu.edu/meded/MOVEMENT/hepato.html

Please read our . This material is indended for use of third year medical students in the Neurology clerkship. Wilson's Disease Wilson's disease is an autosomal-recessive inherited disease caused by a defect on chromosome 143 encording copper transport. All patients with Wilsons have a fundemental defect in the hepatobiliar system and present with a combination of neurologic, psychiatric and musculoskeletal manifestations. Clinical findings include a dementia, a characteristic "wing beating" tremor, and ocular findings (deposition of copper in the cornea, the so-called Kayser-Fleisher ring). There can be a variety of other eye findings including oculogyric crises (Lee et al, 1999). Serum ceruloplasmin levels may be abnormal as is serum copper and urinary copper excretion. Treatment is with copper chelaters (D-penicillamine). Hepatocerebral Degeneration Acquired (non Wilsonian) hepatocerebral degeneration is an uncommon complication of chronic hepatic cirrhosis with spontaneous or surgical portosystemic shunting. It is characterized by a fluctuating but generally progressive course over one to nine years, often punctuated by bouts of acute hepatic encephalopathy. Examination post-mortem reveals foci of destruction of nerve cells and other parenchymal elements and widespread transformation of astrocytes, changes that are very similar to those of Wilson's disease. Pathologic: Portosystemic shunts are always present. The cerebral lesion is localized more regularly in the cortex than in Wilson's Disease. There is a predilection for the parietal and occipital regions and the lenticular nuclei may appear shrunken and discolored. Lesions resembling hypoxic zones are concentrated in vascular border zones. There is usually a sparing of the hippocampus, globus pallidus, and the deep folia of the cerebellar cortex (sites of predilection for anoxic encephalopathy). Microscopically there is widespread hyperplasia of protoplasmic astrocytes in the deep layers of the cerebral cortex, cerebellar cortex, thalamic, lenticular nuclei and other nuclei of the brainstem.

18. Neuroimaging Aspects Of Chronic Acquired Hepatocerebral Degeneration In A Case R RD, Cole M. The acquired (nonwilsonian) type of chronic hepatocerebral degeneration.Medicine 1965; 44345-396. Lockwood AH. Hepatic encephalopathy and other http://med.ege.edu.tr/norolbil/2001/NBD16601.html

Journal of Neurological Sciences (Turkish) Table of Contents NOROL BIL D 18: 2 , 2001 http://www.med.ege.edu.tr/norolbil/2001/NBD16601.html Case Report NEUROIMAGING ASPECTS OF CHRONIC ACQUIRED HEPATOCEREBRAL DEGENERATION IN A CASE REPORT Melda BOZLUOLCAY , Zerrin PELIN , Hayrünissa DENKTAS Istanbul University Cerrahpasa School of Medicine, Department of Neurology, Istanbul , Turkey ABSTRACT Key-words: Chronic acquired hepatocerebral degeneration, magnetic resonance imaging, globus pallidus INTRODUCTION Research using both structural and functional neuroimaging techniques has been under way in an effort to find early markers of brain damage in patients with subclinical hepatic encephalopathy. Structural neuroimaging abnormalities, such as an increased T1-weighted MRI signal intensity in the globus pallidus has been described in cirrhotic patients without overt encephalopathy (4,5,6). These lesions have also been reported in the putamen as well as the mesencephalon in addition to the globus pallidus (7). Also the cerebral cortical and cerebellar atrophy are visualized abnormalities on the MR imaging (8). More recent advances in neuroimaging technology are beginning to reveal unique features in brain of patients with chronic liver failure. However there were very few studies reporting functional neuroimaging (i.e., PET or SPECT) findings (9,10) that may help to understand the nature of lesions in chronic liver disease. In this report, we will discuss the various clinical and radiological features including MR imaging PET and SPECT scan of the CAHD. A case that demonstrated the cognitive impairment and myoclonus was presented.

19. Final Diagnosis -- Case 47 Acquired hepatocerebral degeneration MR and pathologic findings. Exp Neurol 8 318346;Martinez A (1968) Electron microscopy in human hepatic encephalopathy. http://path.upmc.edu/divisions/neuropath/bpath/cases/case47/dx.html

Brain Pathology Case of the Month - February 2000 FINAL DIAGNOSIS: Acquired (Non-Wilsonian) hepatocerebral degeneration with "shunt myelopathy" DISCUSSION: It is well known that patients with severe liver disease may suffer from a reversible neurologic condition known as hepatic encephalopathy [1,6]. Some of these patients suffer from a more permanent neurologic disorder, particularly if they have surgically induced or spontaneous porto-systemic shunts and experience episodes of severe hepatic encephalopathy with coma. Victor, Adams, et al. reported the features of AHCD in detail in a series of 27 cases [14]. These symptoms and signs included progressive dementia, dysarthria, involuntary movements (including tremor, asterixis, and choreoathetosis), ataxia of limb and gait, and mild pyramidal tract signs, typically in a patient with severe hepatic disease and recurrent episodes of coma. Less commonly reported is a progressive spastic myelopathy in association with AHCD [4,12]. Only about 15 cases have been reported in the world literature with detailed pathological descriptions [2,3,7,9,13]. The present case report has several distinctive features. Whereas most reported cases resulted from a surgically created porto-systemic shunt as a treatment for cirrhosis, a few other cases, including this one, are thought to result from spontaneously created shunts (e.g., varices) with the same functional consequences. The published cases usually had Alzheimer II cells in the brain, but only a few had the severe spongy degeneration in the deep cortex illustrated here. Recently, hepatocerebral degeneration has occasionally been documented in vivo by MRI [8,9]. Few electron microscopic studies of human Alzheimer II cells and hepatocerebral degeneration have been published [5,11]. The present report suggests that the vacuolation results from the disruption of astrocytes.

20. Index Acquired hepatocerebral degeneration is characterized by progressive neurologicalsigns; such as disease, with recurrent attacks of hepatic encephalopathy (13 http://www.med.gazi.edu.tr/journal/1998_3_136_138.html

Table of contents CASE REPORTS ACQUIRED HEPATOCEREBRAL DEGENERATION: A CASE PRESENTATION WITH CRANIAL MAGNETIC RESONANCE IMAGING FINDINGS Levent Sinan BÝR, M.D., Reha KURUOÐLU, M.D., Ali Ýhsan BAYSAL, M.D., Ceyla ÝRKEÇ, M.D., Suna AKKUÞ ASLAN, M.D. Gazi University, Faculty of Medicine, Department of Neurology, Ankara, Turkey Gazi Medical Journal 1998; 9 : 136-138 SUMMARY : We present a 54-year-old male patient who had previously been followed with the diagnosis of postnecrotic cirrhosis for twelve years. During the last 4 years, he had developed progressive dysarthria, tremor, and ataxic gait. Neurological examination revealed a mild right hemiparesis with bilateral cerebellar and pyramidal signs. Cranial magnetic resonance imaging study showed cerebral and cerebellar atrophy, as well as bilateral high intensity signals in dentate nuclei and periventricular white matter in T2 weighted images, reminiscent of Wilson's disease. These white matter lesions can also be erroneously diagnosed as multiple sclerosis plaques. Key Words: Brain, Magnetic Resonance Imaging, Liver Diseases.

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