Electroencephalogram in cirrhotic children without clinical encephalopathy

Abstract

Introduction Cirrhosis is one of the most common causes of hospitalization and death in children, so prevention of progressive liver diseases such as hepatic encephalopathy (HE) is critical. In addition to overt HE, subclinical hepatic encephalopathy (SHE) and mild hepatic encephalopathy (MHE) are stages of HE that can only be diagnosed by psychometric and neurophysiological tests, and with early diagnosis and treatment, daily functioning of patients will improve. Therefore, purpose of this study is determining electroencephalogram (EEG) findings in children with cirrhosis without clinical encephalopathy. Methods This study was conducted observationally at Amir Al Momenin Zabol Hospital, Zabol University of Medical Sciences, Iran. In this study, 50 children with cirrhosis without encephalopathy symptoms and 50 healthy children were examined for abnormal electroencephalogram findings. Finally, the data were analyzed using SPSS V22 software. Results The mean and standard deviation of study population age was 57.6 ± 76.17 months. Of a total of 50 children with cirrhosis, 21 (42%) had abnormal EEG findings, whereas no child in the healthy group had abnormal EEG findings. There was a significant association between abnormal EEG findings and older age (P = 0.001), underlying autoimmune hepatitis disease (P = 0.011), and abnormal (elevated) serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) .Children with cirrhosis who had abnormal EEG findings had a higher mean Pediatric End-Stage Liver Disease (PELD) score (18.1 ± 4.1) than patients with normal EEG findings (17.2 ± 3.7), but these findings was not statistically significant or remarkable ( P = 0.073). The sensitivity of EEG for predicting the severity of cirrhosis was estimated to be 70% and the specificity to be 65%. Conclusion The results of this study demonstrate that the higher sensitivity of EEG compared to the specificity in predicting the severity of cirrhosis indicates that EEG can be used to exclude severe cirrhosis or to screen cirrhotic patients at risk of deterioration than in confirming its diagnosis.