Year: 2026
Type: article
Abstract: Hepatic myelopathy (HM) typically occurs in the context of chronic liver disease combined with spontaneous portosystemic shunts. Clinically, the condition usually presents as gradually progressive, symmetrical spastic paraplegia predominantly affecting the bilateral lower extremities, usually without involvement of sensory or sphincter functions. Although studies suggest that this condition does not impact patient survival prognosis, it significantly reduces patients' quality of life. HM has an insidious onset and is often overlooked or misdiagnosed as a neurological disorder. The condition is currently primarily diagnosed through exclusion, with no unified standard yet established. The pathogenesis of HM is not fully understood, but it may be related to gut-derived neurotoxins bypassing the liver via portosystemic shunts and accumulating within the nervous system. Nutritional deficiencies, immunological imbalances, and insufficient spinal cord blood supply may further contribute to disease progression. Early-stage screening and diagnosis are crucial in clinics to prevent irreversible neurological impairment because of the spinal cord nerve damage in the advanced stages of HM. This study focuses on the epidemiology, pathogenesis, clinical manifestations, and treatment strategies, with particular emphasis on the characteristics of neurological function recovery following surgery, aiming to provide a reference for the early identification, stratified assessment, and individualized intervention of HM.
Source: PubMed Central
Institution: Xi'an Medical University
Language: Chinese
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225305552