Hepatic encephalopathy an approach using brainmapping and the quantitative pharmaco-EEG methology

ABSTRACT

In the present study 20 patients with stage II or stage III hepatic encephalopathy were examined by brainmapping and the quantitative pharmaco-EEG methodology. The spectral profile demonstrated in all patients was identical to the pharmaco-EEG profile of the Benzodiazepine [BNZ] receptor agonists [diazepam for example]. This spectral profile was instantanously normalised by injection of flumazenil [Anexate], which is a specific BNZ receptor antagonist. These findings indicate that functional increase in the GABA-ergic tone is the aetiopathogenic factor responsible for the clinical and etectrophysiological changes observed in hepatic enphalopthy and they also indicate that these functional increases in the GABA-ergic tone is mediated allosterically through pathological activation of the brain BNZ receptors probably by endogenous substances with diazepam-Like properties. The implication of these results on the management of hepatic encephalopathy will be discussed