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A 47-year-old female with HCV-related cirrhosis, Child-Turcotte-Pugh class A and a Model for End-Stage Liver Disease (MELD) score of 12, experienced driver license retraction due to excess in car traffic violations. She recently lost her job and she complains about difficulties in concentration. Her husband is worried and suggests visiting a neurologist. She went first to her hepatologist to refer all the changes occurring in her life in the last months.
What should the hepatologist search for and how?
A. Alcohol or psychotropic substances abuse by urine samples
B. Dementia by CT imaging
C. Episodic hepatic encephalopathy by using clinical scales
D. Minimal hepatic encephalopathy by paper and pencil tests
E. Persistent hepatic encephalopathy by an accurate anamnesis
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