Cirrhosis Presenting as Parkinsonism: Two Cases

52 cquired hepatocerebral (or hepatolenticular) degeneration (AHD) is a heterogeneous neurologic disorder which occurs secondary to chronic liver disease and is characterized by neuropsychiatric, cerebellar and extrapyramidal disorders.1 This entity is a neurodegenerative disorder that effects lenticular nuclei and was first described by von Woerkom in advanced liver disease cases that were unrelated to Wilson’s Disease. AHD is usually reported in patients who were known have chronic liver diseases with a porto systemic shunt and previous history of acute hepatic encephalopathy episodes.1-3 On the other hand, chronic liver diseases can Cirrhosis Presenting as Parkinsonism: Two Cases

[1]  X. Hou,et al.  Hepatic encephalopathy coexists with acquired chronic hepatocerebral degeneration , 2015, Neurosciences.

[2]  R. Butterworth.  Parkinsonism in cirrhosis: pathogenesis and current therapeutic options , 2013, Metabolic Brain Disease.

[3]  F. Grandas,et al.  Acquired hepatocerebral degeneration: clinical characteristics and MRI findings , 2010, European journal of neurology.

[4]  J. Jankovic,et al.  Acquired hepatocerebral degeneration , 2009, Journal of Neurology.

[5]  M. Noone,et al.  Cirrhosis presenting as Parkinsonism , 2008, Annals of Indian Academy of Neurology.

[6]  N. Chu,et al.  The natural history of neurological manganism over 18 years. , 2007, Parkinsonism & related disorders.

[7]  R. D. Du Pasquier,et al.  Chronic parkinsonism associated with cirrhosis: a distinct subset of acquired hepatocerebral degeneration. , 2003, Archives of neurology.

[8]  Toshio Shimizu,et al.  Clinical and neuroradiological improvement in chronic acquired hepatocerebral degeneration after branched‐chain amino acid therapy , 2002, Acta neurologica Scandinavica.

[9]  E. Kanal,et al.  Acquired hepatocerebral degeneration: MR and pathologic findings. , 1998, AJNR. American journal of neuroradiology.

[10]  A. Lang,et al.  Chronic acquired hepatocerebral degeneration: Case reports and new insights , 1995, Movement disorders : official journal of the Movement Disorder Society.

[11]  B. G. Çokal,et al.  A Rare Cause of Secondary Parkinsonism: Acquired Hepatolenticular Degeneration: Case Report , 2016 .

[12]  Y. Mishriki.  Puzzles in practice: acquired hepatocerebral (or hepatolenticular) degeneration (AHD). , 2014, Postgraduate medicine.