Evaluation Of The Involvement Of Autonomic Nervous System In Patients of Cirrhosis And It's Correlation with Etiology

Dr Deepak Kumar Warkade; Dr Ruchir Khare

Volume : VII, Issue : IV, April - 2018

Evaluation Of The Involvement Of Autonomic Nervous System In Patients of Cirrhosis And It's Correlation with Etiology

Dr Deepak Kumar Warkade, Dr Ruchir Khare

Abstract :

Introduction: Cirrhosis is among the top ten causes of death worldwide mostly due to alcohol abuse, chronic hepatitis, billiary diseases and iron over load.A wide range of functions are controlled by autonomic nervous system through sympathetic and parasympathetic nervous system. Explanation to increase death rate in cirrhosis not known but is possible that presence of autonomic neuropathy resulting defective response to stressful event. Material & Methods: The study was carried out in patients of cirrhosis in Department of Medicine at N S C B Medical College & Hospital, Jabalpur after informed consent. The duration of study was one year and all simple, non invasive bedside tests of proven value were carried out to test autonomic dysfunction.

Results & Observations: Around 50% of patients were of age group of 40–55 year out of which 15 were male and 9 were female. History of alcoholism was present in 32% cases while 68% cases were non alcoholic. Out of 8 cases of alcohol related etiology 3 belonged to Child A and 5 belonged to Child B & C. In 17 cases of non–alcoholic cirrhosis 6 belonged to Child A and 11 belonged to Child B & C. Most affected test in alcoholic group were VR,E/I ratio, followed by atropine heart rate test. In Non alcoholic cirrhosis VR, E/I ratio and SHG were significantly abnormal.

Conclusions & Summary: This study concludes that autonomic dysfunction is quite common in cirrhosis mostly occurring in the later stage of cirrhosis irrespective of etiology of cirrhosis involving sympathetic and parasympathetic nervous system.