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Previous Volume 340:151 January 14, 1999 Number 2 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: Hepatic myelopathy is characterized by spastic paraparesis and minimal sensory abnormalities in patients with cirrhosis, particularly those with portosystemic shunts that have been created surgically or have occurred spontaneously.^1,2 The pathophysiology of hepatic myelopathy is poorly understood, and the diagnosis can only be made presumptively by excluding other possible causes of spastic paraparesis. Pathological studies show loss of myelin in the lateral corticospinal tracts of the spinal cord. Unlike hepatic encephalopathy, hepatic myelopathy is usually considered irreversible (this was true even after liver transplantation in one patient³).

We treated a 60-year-old woman with cirrhosis caused by . . . [Full Text of this Article]

References

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• Wong, S H, Boggild, M, Enevoldson, T P, Fletcher, N A (2008). Myelopathy but normal MRI: where next?. PN 8: 90-102 [Abstract] [Full Text]  
• Gospe, S M Jr, Caruso, R D, Clegg, M S, Keen, C L, Pimstone, N R, Ducore, J M, Gettner, S S, Kreutzer, R A (2000). Paraparesis, hypermanganesaemia, and polycythaemia: a novel presentation of cirrhosis. Arch. Dis. Child. 83: 439-442 [Abstract] [Full Text]