Weissenborn K
Neurologische Klinik der MHH, Hannover.
Schweiz Rundsch Med Prax. 1994 Sep 20;83(38):1059-64.
With respect to the grade of disturbance of consciousness on one hand and concomitant cognitive, psychic and neuromuscular symptoms on the other hand several stages of portosystemic encephalopathy (PSE) are differentiated; moreover, it could recently be demonstrated that a remarkable proportion of cirrhotics without any clinical sign of cerebral dysfunction shows pathological results in psychometric and neurophysiological examinations. Therefore, the stage of subclinical, latent PSE was defined additionally. The assessment of subclinical PSE is usually done using paper-pencil tests or neurophysiological examinations like the EEG. The diagnosis of manifest PSE is made with respect to clinical criteria. Other possible causes of cerebral dysfunction have to be excluded by laboratory, neurological and eventually radiological examination. Therapy of PSE aims at the reduction production and resorption of ammonia. New therapeutic approaches, which have been proposed with regard to pathophysiological aspects of PSE other than ammonia, have not yet been established.
一方面根据意识障碍程度，另一方面依据伴随的认知、精神及神经肌肉症状，对门体分流性脑病（PSE）的几个阶段进行了区分；此外，最近有研究表明，相当一部分没有任何脑功能障碍临床症状的肝硬化患者在心理测量和神经生理学检查中显示出病理结果。因此，额外定义了亚临床、潜伏性PSE阶段。亚临床PSE的评估通常使用纸笔测试或脑电图等神经生理学检查。显性PSE的诊断依据临床标准。必须通过实验室、神经学检查以及最终的放射学检查排除脑功能障碍的其他可能原因。PSE的治疗旨在减少氨的生成和吸收。针对除氨以外的PSE病理生理学方面提出的新治疗方法尚未确立。
