Differentiation of minimal and grade 1 hepatic encephalopathy using neurophysiological, neuropsychological, magnetic resonance spectroscopic, and systemic inflammatory parameters

BACKGROUND Hepatic encephalopathy (HE) is traditionally classified as overt and minimal HE (MHE). The International Society for HE and Nitrogen Metabolism clubbed MHE and grade 1 HE as “covert” HE. However, these appear to be distinct entities. AIM To compare inflammatory markers, magnetic resonance spectroscopy (MRS), Bispectral index (BIS), spectral electroencephalography (EEG), and natural history of MHE and grade 1 HE. METHODS In this prospective study, 150 patients with cirrhosis were categ