Clinical and Experimental Evidence of Cirrhosis-Related Parkinsonism

Clinical Evidence Of Chronic Parkinsonism In Advanced Liver Disease

Dering thelast century, particularly the first half,considerable attention was dedicated to the characterization of cirrhosis-related brain disorders(Stadler, 1935; Van Woerkem, 1914; Wilson, 1971)through clinico-pathological approaches of single cases or small series. While, the first establishment of the term “acquired type of chronic hepatocerebral degeneration” was elaborated by Victor et al in 1965(Victor et al., 1965), which intended to make a distinction from Wilson disease; a primarily genetic liver disease associated to copper accumulation due to the gene ATP7B mutation encoding for a transmembrane copper-transporting ATPase, which impacts several organs including the brain(Członkowska et al., 2018).Since, different aspects were defined including a wide range of neuro-cognitive disorders arising from chronic liver failure, different from those associated to acute and transient episodes of HE (Victor et al., 1965 ;Finlayson & Superville, 1981; Levy et al., 1983; Toghill et al., 1967; Weissenborn & Kolbe, 1998). Most of these symptoms refersto BG dysfunctions with abnormal involuntary movements including tremor, myoclonus, choreoathetosis, dystonia, rigidity, and dysarthria along with ataxia, pyramidal tract signs, and dementia (Jog & Lang, 1995).