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The following is a summary of “Role of multifocal visual evoked potential in detection of minimal hepatic encephalopathy in patients with compensated liver cirrhosis,” published in the February 2025 issue of BMC Neurology by Sabry et al. 

Minimal hepatic encephalopathy (MHE) is a debilitating complication of cirrhosis. Visual evoked potential (VEP) has been used for diagnosis, while multifocal visual evoked potential (mfVEP) offers topographic recording to overcome VEP’s limitations. 

Researchers conducted a retrospective study to detect MHE in cirrhotic patients using mfVEP, comparing it with psychometric hepatic encephalopathy score (PHES), paired associative learning (PAL), and the benton visual retention test (BVRT). 

They enrolled 45 patients with compensated hepatic cirrhosis and 45 age, sex, and education-matched controls. Multifocal visual evoked potential (mfVEP) and psychological tests (PHES, PAL, BVRT). 

The results showed that 14 patients had MHE according to PHES, 15 had abnormal mfVEP, and 11 and 10 had abnormal BVRT and PAL, respectively. mfVEP showed the highest sensitivity for detecting MHE compared to PHES. The mfVEP and possibly BVRT can detect subtle abnormalities in patients with non-MHE cirrhotic, requiring further research and follow-up. 

Investigators found that mfVEP demonstrated promising results for the objective early detection of MHE, with a sensitivity of approximately 92.9%. 

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-025-04031-9