Open AccessSpastic paraparesis associated with advanced liver cirrhosis: a condition obscure in terms of treatment and prognosis
Author(s) -
Jaspreet Kaur,
Gautam Jesrani,
Meena Gupta,
Sarabmeet Singh Lehl
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2020-235090
Subject(s) - medicine , spastic , cirrhosis , hepatic encephalopathy , complication , chronic liver disease , shunting , surgery , encephalopathy , disease , liver disease , gastroenterology , physical therapy , cerebral palsy
Hepatic myelopathy or spastic paraparesis of liver disease is an insidious onset condition with pure motor spastic paraparesis without sensory, bladder or bowel involvement in patients with chronic liver disease, in which the neurological dysfunction cannot be explained by other causes. It is a rare, relentlessly progressive and mostly irreversible neurological complication resulting from portosystemic shunts occurring spontaneously, created surgically or due to 'functional shunting'. In some cases, no evidence of shunting is elicitable due to difficulty in locating the hidden collaterals. We report this rare case of a 33-year-old man with chronic liver disease presenting with spastic paraparesis after 11 months of resolution of an episode of hepatic encephalopathy.