Hepatic encephalopathy mimicking stroke: A case report

J. W. Atchison*, M. Pellegrino, P. Herbers, B. Tipton, V. Matkovic

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


This case demonstrates focal neurologic deficit mimicking stroke with underlying hepatic encephalopathy. Unilateral weakness in patients with hepatic encephalopathy has not been previously described in the English language literature. A 46-yr-old white woman was admitted to an acute care hospital for left shoulder manipulation, underwent general anesthesia and appeared to have had a right cerebrovascular accident. At transfer to the rehabilitation hospital, in addition to the left hemiparesis, there were inconsistencies in the neurologic examination and signs of cognitive impairment and liver failure. The patient's response to an intensive, multidisciplinary inpatient rehabilitation program along with treatment of the liver dysfunction led to resolution of left-sided weakness and flapping tremor with independence in ambulation and activities of daily living. Relevant literature is reviewed. A thorough history and physical examination with liver function assessment should always be performed in patients with cerebrovascular accident and unusual recovery.

Original languageEnglish (US)
Pages (from-to)114-118
Number of pages5
JournalAmerican Journal of Physical Medicine and Rehabilitation
Issue number2
StatePublished - Jun 1 1992


  • Ammonia
  • Encephalopathy
  • Rehabilitation
  • Stroke

ASJC Scopus subject areas

  • Rehabilitation
  • Health Professions(all)
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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