Annals of Indian Academy of Neurology
IMAGES IN NEUROLOGY
Year
: 2014  |  Volume : 17  |  Issue : 2  |  Page : 204--206

Acute stroke-like presentation of acquired hepatocerebral degeneration


B. Smita, V. Abdul Gafoor, K. Saifudheen, James Jose 
 Department of Neurology, Government Medical College, Calicut, Kerala, India

Correspondence Address:
B. Smita
Department of Neurology, Government Medical College, Calicut - 673 008, Kerala
India

Neurological manifestations in liver diseases have been well-described. Parkinsonism developing in cirrhotic patients is a unique clinical, neuroradiological, and biological entity. The symptoms are often insidious in onset and occur after liver disease has made its presentation. Acute dysarthria as the presenting manifestation of cirrhosis is rare. Here we report three cases where liver disease made an unusual presentation as acute dysarthria. In all cases the abruptness of the onset prompted the treating physicians to make a diagnosis of stroke. The computed tomography (CT) scans of all these patients did not show any evidence of stroke. This was followed by magnetic resonance imaging (MRI) which showed the characteristic symmetric high-signal intensities in globus pallidus and substantia nigra in T1-weighted images, a reflection of increased tissue concentrations of manganese that helped in making a retrospective diagnosis of liver disease, confirmed later by altered serum albumin to globulin ratios and altered liver echo texture in ultra sonogram.


How to cite this article:
Smita B, Gafoor VA, Saifudheen K, Jose J. Acute stroke-like presentation of acquired hepatocerebral degeneration.Ann Indian Acad Neurol 2014;17:204-206


How to cite this URL:
Smita B, Gafoor VA, Saifudheen K, Jose J. Acute stroke-like presentation of acquired hepatocerebral degeneration. Ann Indian Acad Neurol [serial online] 2014 [cited 2022 Jan 26 ];17:204-206
Available from: https://www.annalsofian.org/article.asp?issn=0972-2327;year=2014;volume=17;issue=2;spage=204;epage=206;aulast=Smita;type=0