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The effects of the benzodiazepine antagonist flumazenil were studied in 20 episodes of hepatic encephalopathy(HE)in 17 patients with acute(n=9)or chronic(n=8)liver failure who had not responded to conventional therapy. Patients with a history of benzodiazepine intake were excluded.Changes in HE stage,in Glasgow coma scale,and in somatosensory evoked potentials were measured.In 12 of 20 episodes HE stage improved.The response to treatment occurred rapidly(within 3-60 min).In 8 of these 12 episodes HE worsened 0. 5-4 h after treatment.In 5 of the 8 episodes that did not respond to flumazenil patients had clinical evidence of brain oedema.Flumazenil may be valuable in the treatment of HE in acute and chronic liver failure. |
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