Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neurophysiology

Back ground: Liver cirrhosis is a global health problem which could be associated with several neurological manifestations.Numbness,fatigue and muscle cramps are frequently complaining symptoms in these patients. Objective: Early detection of peripheral neuropathy and loss of motor units, among patients of liver cirrhosis by motor unit number estimation (MUNE).In addition, finding out correlation between peripheral neuropathy and severity of the liver cirrhosis. Methods: This cross-sectional study conducted on fifty-six liver cirrhotic patients (Group-1), and sixty-one age/gender matched healthy controls (Group-2). The recruited patients were clinically assessed. For all the allocated cirrhotic patients, conventional nerve conduction studies (NCS) as well as quantitative electromyography (Q-EMG) were performed.Interference pattern analysis (IPA) and MUNE were the Q-EMG techniques studied. Results: Liver cirrhosis wassecondary to Hepatitis 2C3 viral (HCV) infection in (80.3%) of the patients.Most of the liver cirrhotic patients were classified as Child-Pugh 2A3 class (62.5%).The most common encountered symptoms by the patients were muscle cramps (64.3%) and fatigue (35.7%). Group-1 was further subdivided into two subgroups; depending on their manifestations; manifested (Group-1A) which included 80.4% of studied patients, and non-manifested (Group-1B), includedthe remaining 19.6% of allocated patients. 28.6% of the studied cases had peripheral neuropathy by nerve conduction studies, that was significantly correlated to Child-Pugh classification (p-value <0.001) as well as (Model for End Stage Liver Disease) MELD score (P-value= 0.014)

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