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Spontaneous remission of hepatic myelopathy in a patient with alcoholic cirrhosis:A case report

World Journal of Clinical Cases 2022年第30期10卷 11172-11177页

作者： Chun-Yan Chang Chen Liu Fang-Fang Duan Hang Zhai Shan-Shan Song Song Yang Division Third Center of Hepatology Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China

BACKGROUND hepatic myelopathy(HM)is a rare neurological complication of advanced *** of patients with HM is generally poor without timely liver transplantation or interventional ***-resolving HM in patients with alcoholic cirrhosis has never been *** SUMMARY A 53-year-old man with alcoholic cirrhosis and recurrent overt hepatic encephalopathy for 1 year was admitted for lower extremity weakness,slow movement,and stumbling *** patient was diagnosed with HM after excluding other causes of spastic *** patient refused liver ***,the patient kept total abstinence and received a multidisciplinary treatment for complications of decompensated *** symptoms of HM resolved gradually after 2 years of *** complications of alcoholic cirrhosis resolved after 4 years of *** The case demonstrates that HM can resolve in patients without liver transplantation after total abstinence and systemic management of complications.

关键词： Alcoholic cirrhosis hepatic myelopathy hepatic encephalopathy Spastic paraparesis Therapeutics Case report

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hepatic myelopathy:Morphology of the thoracic and lumbar cord in liver cirrhosis and non-cirrhosis corpses and comparison of neuron functional protein

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Neural Regeneration Research 2011年第29期6卷 2273-2278页

作者： Yu Lei Zhen Liu Huilong Huang Suiliang Zhang Yunheng Zhou Shuai Wu Xiaojun Hou Jie Gong Aiqun Wu Department of Clinical Medicine the Second Military Medical University of Chinese PLA Shanghai 200433 China Department of Anatomy the Second Military Medical University of Chinese PLA Shanghai 200433 China Department of Interventional Therapy Eastem Hepatobiliary Surgery Hospital the Second Military Medical University of Chinese PLA Shanghai 200433 China Clinical Laboratory Shanghai Armed Police Corps Hospital Shanghai 201103 China Department of Neurology Changhai Hospital the Second Military Medical University of Chinese PLA Shanghai 200433 China

The current study demonstrated that injury of the spinal cord lateral funiculus occurs in liver cirrhosis. This study sought to compare the morphology of the thoracic and lumbar cord, the expression of functional proteins, and changes in vessels between liver cirrhosis and non-cirrhosis corpses. Results showed that in the liver cirrhosis group, the hepatic vein expanded, the gastrointestinal tract was full of coagulated blood, blood-stasis was easily seen in the veniplex of the vertebral canal and the lumbar spinal cord, and the cell bodies of the anterior horn in the thoracic and lumbar cord were smaller than those in non-cirrhosis corpses. In addition, nerve cells shrank, Nissl bodies were concentrated with obscured nuclei, and neurofilament and synapsin containing cell bodies of the anterior horn and white matter decreased in the liver cirrhosis group. These experimental findings indicate that abnormal circulation of the spinal cord, resulting from hemodynamic change of cirrhotic portal hypertension, may be the most significant cause of hepatic myelopathy.

关键词： hepatic cirrhosis portal hypertension hepatic myelopathy synapsin neurofilament

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