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Hepatic Encephalopathy and Driving

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Book cover Hepatic Encephalopathy

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Hepatic encephalopathy is characterized as a spectrum of neuro-cognitive impairment that ranges from overt disturbances to minimal hepatic encephalopathy (MHE). MHE patients have deficits in attention that are compounded by impaired response inhibition, working memory, and visuo-motor coordination. All these are important skills for driving a vehicle. Adding to this impairment is the lack of insight and predisposition to fatigue. These patients lack the neurologic exam findings and historical symptoms for diagnosis, and as MHE is estimated to have a prevalence of 22–80%, this becomes particularly important when pertaining to the responsibility of driving an automobile or commercial vehicle. Diagnosis of MHE requires specialized testing and is often difficult to detect, and physician reporting to state driver regulatory organizations is riddled with ethical and legal dilemmas. Significant strides have been made in better understanding how MHE affects patient’s everyday lives, including important functions such as driving. This improved understanding will improve awareness and road safety for both patients with cirrhosis and other chronic illnesses as well as the general public.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Virginia Commonwealth University Health Systems and Physicians, 1250 East Marshall Street, 980509, Richmond, VA, 23298-0509, USA

    Matthew R. Kappus MD

  2. Department of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA

    Jasmohan S. Bajaj MBBS, MD, MS

Authors
  1. Matthew R. Kappus MD
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  2. Jasmohan S. Bajaj MBBS, MD, MS
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Corresponding author

Correspondence to Jasmohan S. Bajaj MBBS, MD, MS .

Editor information

Editors and Affiliations

  1. , Division of Gastroenterology, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, 44145, USA

    Kevin D. Mullen

  2. , Division of Gastroenterology, MetroHealth Medical Center, 2500 MetroHealth Medical Center, Cleveland, 44145, USA

    Ravi K. Prakash

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Kappus, M.R., Bajaj, J.S. (2012). Hepatic Encephalopathy and Driving. In: Mullen, K., Prakash, R. (eds) Hepatic Encephalopathy. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-836-8_15

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  • DOI: https://doi.org/10.1007/978-1-61779-836-8_15

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  • Publisher Name: Humana Press, Totowa, NJ

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  • Online ISBN: 978-1-61779-836-8

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