Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To identify the associated factors of bradykinesia in cirrhotic patients.
Background: Reviews of the literature always mention the asterixis as a well-known examination to diagnose the hepatic encephalopathy. However, it is still less sensitive to detect the low-grade hepatic encephalopathy.
Methods: From eighty-three patients of the research project, Movement Disorders in non-Wilsonian Hepatic Cirrhotic Patients, 28 cases of bradykinesia (15 males, 13 females) were conducted in the statistical analysis. The characteristics were patients with a certain degree of sluggish manual dexterity, especially the finger tapping, without the presence of cogwheel rigidity. Researchers considered gender, etiologies of cirrhosis, cirrhosis-related complications, hepatic encephalopathy, medical illnesses, and some of the neurological deficits as potential factors associated with this movement disorder. Implemented were the Chi-square test, Fisher-Exact test, and logistic regression.
Results: The bradykinesia found in this study was a slow finger tapping. The clinical feature was a delayed tapping onset without a decrease in the tapping width. Women were dominant with a higher percentage of gender than men (males 15.2%, females 29.5%). This gender difference yielded a significant effect (p=0.04). The Chi-square and Fisher-Exact tests of the prevalence of bradykinesia and the different etiologies of hepatic cirrhosis revealed no significance. Portal hypertension and hepatocellular carcinoma also showed no significance. Contrarily, the low-grade hepatic encephalopathy had a statistical significance (p<0.001). Analysis of all the confounder’s effects was inconsequential. The univariate and multivariate analysis confirmed that the factors associated with bradykinesia were being of the female gender (p<0.05), and hepatic encephalopathy (p<0.001). The jerky pursuit was one of an abnormal ocular movement seen. The feature was the disruption of pursuit eye movement which significantly related to hepatic encephalopathy (p<0.05) and also bradykinesia (p<0.05).
Conclusions: The bradykinesia and jerky pursuit eye movement had the significant association with the hepatic encephalopathy. Further studies to evaluate the diagnostic value of these two signs for an early detection of mild hepatic encephalopathy should be conducted.
To cite this abstract in AMA style:K. Methawasin, P. Chonmaitree, C. Wongjitrat, S. Rattanamongkolgul, T. Asawavichienjinda. The finger tapping and disrupted smooth pursuit to detect the hepatic encephalopathy: Results of the subgroup analysis of movement disorders in non-Wilsonian hepatic cirrhotic patients [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/the-finger-tapping-and-disrupted-smooth-pursuit-to-detect-the-hepatic-encephalopathy-results-of-the-subgroup-analysis-of-movement-disorders-in-non-wilsonian-hepatic-cirrhotic-patients/. Accessed December 5, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-finger-tapping-and-disrupted-smooth-pursuit-to-detect-the-hepatic-encephalopathy-results-of-the-subgroup-analysis-of-movement-disorders-in-non-wilsonian-hepatic-cirrhotic-patients/