1Division of Gastroenterology & Hepatology, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB H 538, Newark, NJ 07103, USA.
2Division of Gastroenterology & Hepatology, Rutgers New Jersey Medical School, 185 South Orange Avenue, MSB H 538, Newark, NJ 07103, USA. Electronic address: firstname.lastname@example.org.
The diagnosis of hepatic encephalopathy is predominantly clinical, and the tests available assist in the diagnosis only by excluding other causes. Covert hepatic encephalopathy, which is defined as abnormal performance on psychometric tests when standard neurologic examination is completely normal, has gained widespread attention in recent years due to its effect on quality of life. This review focuses on the tests available to aid in the diagnosis of this significant complication of liver disease, and discusses the complex pathophysiologic mechanisms identified through new imaging techniques and their significance toward development of new therapeutic targets for this condition.