Hepatic Encephalopathy Test.

[Richard-Allen]

I think a lot of people who have experienced server Liver Disease will know that Hepatic Encephalopathy (HE), is a terrible condition to not only have, but to try and live with too. In my opinion, a lot of GP’s don’t give this condition the medical attention it deserves.

Families and loved ones don’t always understand the emotional turmoil that can unfold with this condition. In my case, it was just a case of, “Take this medicine three times a day”. Nothing as to the cause or of the long term prognosis was ever explained to me, or my wife. My confusions and frustrations would often boil over into a torrent of verbal abuse. Only through my own learnings of this condition was I able to fully understand what was going on. I have also now learnt that treatment of this condition varies from region to region. I was prescribed lactulose, while others are prescribed Lactulose and Rifaximin, or other forms of medication.

It would appear that in certain parts of the country, other tests are sometimes carried out to try and assess the amount of damage being caused in the brain. I certainly was never offered any such tests. As a result, I still suffer from Encephalopathy episodes, post-liver transplant.

I have since found out that there is a simple test that’s used in America and across Europe. This test is known as, “The Animal Naming Test” and I am grateful to NinaNon for informing me of this simple, but reliable test.

Here 36 pictures of animals are laid out, and a person has to name each animal. It sounds easy, and it is, but a person with HE will most likely identify a dog or a cat but will stumble or have difficulty naming some of the others. A score is then used to assess the amount of brain damage that is being caused.

This test has been available since 2017, I suspect that most of the GP’s in our country have never heard of it.

Early identification of HE is imperative to prevent more permanent brain damage from being caused. I shall be making more doctors and GP’s in my area aware of this simple test in the future.

This article is in German, but by selecting, “Translate” on your web browser you should be able to read it in English. There is more information about this test out there and available online: medical-tribune.de/medizin-...

[Hidden]

Thank you so much for sharing. I will have a look 👍😊

[Hidden in reply to Hidden]

Hi

I found this very interesting and looks a much better way to test for HE

[Fibro2021]

Thanks for the interesting information. Usually doctors use a number-connection test to diagnose hepatic encephalopathy (НЕ). But this is probably a desirable situation and not a mass phenomenon.Information about the test can be found here google.com/url?sa=t&source=...

You can take the number connection test online at the link. liverandbrain.com/the-liver...

Any interpretation of this test is done by a specialist, as there is no specific “HE test,” a diagnosis of HE is often referred to as a diagnosis of exclusion. This means that it is important for your doctor to rule out other possible causes of your symptoms in order to correctly diagnose HE.

[Richard-Allen in reply to Fibro2021]

Many thanks for your reply Fibro,

one of the problems we have here in the UK is that doctors (General Practitioners) have a very limited amount of time to identify and offer treatment to patients. Here they sometimes only get to spend 10 - 15 minutes with a person due to the pressures and demand on the health service.

When it comes to diagnosing HE, the majority of doctors simply see this as being a liver-related condition and prescribe Lactulose or Rifaximin. These are, (as you’ll know) just preventative treatments to prevent further damage to the brain. Very rarely are any tests carried out to see how much brain damage has occurred, as this now becomes a neurological condition and not a liver one.

I have been trying to raise awareness of this lack of understanding to GP’s but it’s hard to bring about change.

The other aspect that is also over-look is the change in mood and personality. This often goes unexplained to family members by the GP’s. This brings about a lack of understanding and frustration from those who just don’t understand what is happening. Marriages have failed, and families have broken up, all because they don’t realise that hepatic encephalopathy is a brain disorder and that the person in their confused state of mind, isn’t being nasty on purpose.

This lack of understanding by others can cause so much emotional pain and suffering on top of an already confused state of mind.

Many thanks for your comments, which I totally agree with.

Best Wishes

Richard