الفهرس 
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Abstract
Subdclinical hepatic encephalopathy (SHE) is a condition in which patients with cirrhosis exhibit various quantifiable neuropsychological defects, but have a normal mental and neurological status on standard clinical examination. It has been conclusively shown that SHE has a significant bearing on subtle brain cognitive functions and so, on the quality of daily life.
Since the hepatobiliary rout is important for the excretion of manganese (Mn), decreased elimination via biliary excretion and increased systemic availability dure to portal – systemic shunting are associated with increased manganese level in the systemic
It has been demonstrated that mn plays an important role in the pathogenesis of HE. In cirrhotic patients, mn was found to accumulate in the brain especially in the basal ganglia producing extrapyramidal motor symptoms, together with brain cognitive impairment.
The aim of this work was to study the brain cognitive functions and their relation to serum manganese level in patients with subclinical hepatic encephalopathy.