Hepatic Encephalopathy (shaky handwriting)?

[InquisitiveOne]

I am new here and hoping for some help so I can decide on possible next steps.

I’m a previous heavy drinker (quit permanently last fall) and I think I may have suffered a mild HE bout earlier last year. I was mildly distracted and irritated at small things for awhile and one day I woke up and could not hold a pen. I had to hold my right hand with my left hand to write. Once I got the strength back in my right hand my writing was shaky for about 30 hours and then I was back to my normal self. It’s only happened once.

I’m wondering if this has happened to anyone? Also wondering if anyone knows if this is caused by decompensated cirrhosis and/or portal hypertension?

(All non fasting blood tests are normal, ie ALT, AST, ALP, GGT, Bilirubin. Physical exam normal. Blood thinner daily for Factor V Leiden.). Thinking of having scans.

[InquisitiveOne]

I should have said my blood tests were taken 3 months after I quit drinking and several months after the episode.

[Hidden]

Have you been diagnosed with cirrhosis?

[InquisitiveOne in reply to Hidden]

I have not been diagnosed with cirrhosis but am wondering if that could be what caused this.

[Hidden in reply to InquisitiveOne]

Doubt it, if all your bloods are OK.

[InquisitiveOne in reply to Hidden]

Thank you, Maco100. I’ve not seen any posts with my symptoms so I wanted to check!

[Ubwa]

I wouldn't read too much into the shaky hands for 30 hours, Alcohol affects pretty much everything. If it was due to cirrhosis or PH your would have had recurrent events more than likely. Go on what your docs say, if bloods look good and no other symptoms sounds like you dodged a bullet 👍

[InquisitiveOne in reply to Ubwa]

Thank you, Ubwa. I’ve been worried for months and thought I’d ask here since you are all so knowledgeable. I’m sorry for editing this post but I forgot to mention that I was not feeling well for a few months during the time this episode happened (tired/nauseated/dizzy) but that went completely away after I quit drinking. (Then with the worry came upper right quadrant pain for the first time ever, 4 months after abstinence and gone now so I attribute that to anxiety.)

[Hidden]

I had the shaky hands and my writing looked like chicken scratch.. That lasted for quite awhile. I could barley fill out a legible form at the doctors office. Back to normal now..

[InquisitiveOne in reply to Hidden]

NelsonAlgren are you free of cirrhosis?

[Hidden]

Nope. I have cirrhosis. Diagnosed 7 years ago. Still "very well compensated"..

[InquisitiveOne in reply to Hidden]

Thanks for letting me know. I didn’t know you could have the shaky handwriting and have compensated cirrhosis.

[Tina_1234]

Hi,

This is mainly normal in liver failure. As your liver is the one cleaning your body from toxins, and now it's not working properly, you will have a build up of toxins in your body. Your doctor should give you laxatives and rifaximin. Laxative will make you go to the toilet several times a day to get rid off the toxins and rifaximin is an antibiotic preventing HE. You really need to get that going. Good luck with everything.

[InquisitiveOne in reply to Tina_1234]

Thank you, Tina_1234

[Roy1955 in reply to InquisitiveOne]

I don't think what Tina is commenting on has any relationship to your current health inquisitive one!

[InquisitiveOne in reply to Roy1955]

Roy155, thank you. I was getting a little scared.

[Hidden]

I should make it clear. I had VERY shaky handwriting for awhile but no doc ever told me I had HE. And my ammonia levels have never been high.

[InquisitiveOne in reply to Hidden]

Thanks Nelson.

[Flowergirl24]

I had HE pre transplant and did not have shaky hands.

[InquisitiveOne in reply to Flowergirl24]

Thank you Flowergirl24