Ataxia and tremor in patients with liver cirrhosis and minimal hepatic encephalopathy

Severe grades of Hepatic Encephalopathy (HE) go along with a variety of motor symptoms like ataxia, „mini-asterixis“ and asterixis. Recently, it has been shown that „mini-asterixis“ in HE is due to a general slowing of motor cortex drive (Timmermann et al., Neurology 58: 295–298) and thalamo-cortical coupling (Timmermann et al., Neurology 61: 689–692). However, it remained unclear whether HE patients show ataxia already at low grades that could be detected in clinical scoring. We therefore tested 17 patients with liver cirrhosis proved by clinical examination, laboratory findings and ultrasound/cat-scan of the l…