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April2013 Vol.50 Issue:        2        Table of Contents
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Neuropsychiatric Manifestations of Hepatocellular Carcinoma

Adel Hassanein1, Montasser Hegazy1, Al- Metwally A. Youssof1,

Gihan Ramzy1, Mohammed El-Sayed2, Yasser M. Abdelhamid3

Departments of Neurology1, Tropical Medicine2, Internal Medicine3; Cairo University; Egypt



Background: Hepatocellular carcinoma is the fifth most common cancer in the world. The neurological manifestations of hepatocellular carcinoma (HCC) include central nervous system dysfunction e.g. hepatic encephalopathy and peripheral nervous system dysfunction through a paraneoplastic myositis and peripheral neuropathy. Objectives: To assess the neuropsychiatric manifestations in patients with hepatocellular carcinoma on top of hepatitis C virus (HCV) liver cirrhosis. Methods: Fifty subjects; 40 patients and 10 healthy volunteers. Patients were subdivided into 3 subgroups: Group I: It included 20 patients with HCC on top of hepatitis C liver cirrhosis. Group II: It included 10 patients with chronic HCV without liver cirrhosis. Group III: It included 10 patients with chronic HCV with liver cirrhosis.IV: it included 10 healthy volunteers. All the patients were subjected to neuropsychiatric and electrophysiological assessment and hepatological evaluation including abdominal ultrasonography and alpha fetoprotein assay. Results: There were a highly statistically significant difference in the mean values of the score of neuropsychometric tests between all groups and normal control group and significant impairement in neuropsychometric tests in HCC group compared to the other groups (p<0.05). In HCC patients, there was a statistically significant positive correlation between the values of maximum diameter of the tumor and the scores of Hamilton depression scale (p<0.05). Conclusion: We conclude that HCC patients on top of HCV liver cirrhosis were found to have more depression and fatigue than HCV cirrhotic patients. Both HCC patients and HCV cirrhotic were found to have memory impairement and different types of peripheral neuropathy either clinically or subclinically. [Egypt J Neurol Psychiat Neurosurg.  2013; 50(2): 177-186]

Key Words: Neuropsychiatric manifestations -Hepatocellular carcinoma- HCV- Liver cirrhosis.

Correspondence to Adel Hassanein, Department of Neurology, Cairo University, Egypt. Tel.: +201001476573

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