NEUROMUSCULAR DEFECTs IN CHRONIC LIVER DISEASE

Abstract

Liver cirrhosis is one of the most important medical problems in Egypt. Muscle wasting and weakness are well-known complications of liver cirrhosis. The present study was planned to assess the neuromuscular system in patients with chronic liver disease. 70 patients were evaluated as regard the degree of liver disease and the peripheral nerve function. The nutritional status of the patients was evaluated with an estimation of lean body mass from 24-h urinary creatinine excretion. Manual muscle strength at hip, knee, ankle, shoulder, elbow and wrist were also assessed. Muscle biopsies were obtained from 34 patients only home coagulation profile allows the procedure safely. 20 healthy subjects were evaluated as a control group. Data obtained were evaluated with respect to the severity of liver disease. Peroneal nerve conduction velocity was found to be

impaired more than that of the median nerve. However no significant correlation was found between the severity of neuropathy and the severity of liver disease. The underlying mechanism of such peripheral neuropathy is mostly due to axonal degeneration. Neither the presence of ascites nor the presence esophageal varices had significant effect on the degree of nerve conduction.