Study of prevalence and pattern of peripheral neuropathy in patients with liver cirrhosis

Abstract

Background: Peripheral neuropathy is not an uncommon complication of liver cirrhosis but it is not given much clinical relevance. The pattern and prevalence of peripheral neuropathy has also not been studied extensively. Alcohol use, coexisting diseases and nutritional deficiency have been postulated as factors responsible for neuropathy. The aim of this study was to define the pattern and prevalence of neuropathy in cirrhosis and to determine any etiologic correlation.Methods: 85 patients of cirrhosis of liver were studied. Apart from routine investigations, serum vitamin B12 estimation was also done in these patients. Electrophysiological studies were done in 46 patients.Results: Alcohol was the most common etiology of cirrhosis (57.6%). Hepatitis B related (11.8%) and Hepatitis C (4.7%) were other etiologies. The prevalence of peripheral neuropathy by electrophysiological studies was found to be 67.39% in cirrhosis of any etiology, of which 43.5% had sensorimotor type and the predominant pattern of peripheral neuropathy was mixed axonal degeneration and demyelination. The peripheral neuropathy was significantly more (p=0.01) in child class C than other child classes. Prevalence of neuropathy had no significant difference (p=1.00) between alcoholic and non-alcoholic cirrhosis. No correlation was present with either serum vitamin B12 levels or blood glucose levels.Conclusions: Peripheral neuropathy is present in more than half of cirrhosis patients and is unrelated to etiology and nutritional status but related to the severity of cirrhosis.