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Michael Fisman, MD, FRCP(C)
Psychogeriatric Unit London Psychiatric Hospital PO Box 2532, Terminal A London, Ontario, Canada N6A 4H1

Arch Neurol. 1987;44(10):997.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—I read with interest the report by Nakano et al,¹ in the January issue of the ARCHIVES, on hepatic ultrastructural change and liver dysfunction in amyotrophic lateral sclerosis. This adds to the list of degenerative disorders of the central nervous system associated with evidence of hepatic dysfunction. Subtle changes in liver function have also been described in Creutzfeldt-Jakob disease²; and hyperammonemia, possibly due to hepatic dysfunction, has been described in Alzheimer's disease.³ Whether the hepatic disturbances are related to the underlying cause of the disease or, rather, are secondary effects related to disease progression, drug toxicity, nutritional inadequacy, or unrelated illness, must await further study.

A unitary hypothesis to explain the concurrence of hepatic and central nervous system changes would implicate a common etiopathogenetic agent, eg, a direct effect of the Creutzfeldt-Jakob transmissible agent both on brain and on hepatic function. Similarly, the concurrence . . . [Full Text PDF of this Article]

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