Improvement of Hepatic Myelopathy after Liver Transplantation

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Abstract
Hepatic myelopathy is characterized by spastic paraparesis and minimal sensory abnormalities in patients with cirrhosis, particularly those with portosystemic shunts that have been created surgically or have occurred spontaneously.1,2 The pathophysiology of hepatic myelopathy is poorly understood, and the diagnosis can only be made presumptively by excluding other possible causes of spastic paraparesis. Pathological studies show loss of myelin in the lateral corticospinal tracts of the spinal cord. Unlike hepatic encephalopathy, hepatic myelopathy is usually considered irreversible (this was true even after liver transplantation in one patient3).

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