Successful long-term outpatient treatment of chronic hepatic encephalopathy by intravenous administration of flumazenil.

Treatment of chronic hepatic encephalopathy is difficult. Oral flumazenil has been proposed for long-term treatment but is not presently avalaible on the market. We report the successful treatment of one case of chronic hepatic encephalopathy in cirrhosis without precipitating factors by low dose intravenous injections of flumazenil (Anexate(R), 1 mg/4 hours). Flumazenil is expensive and not always effective. We suggest reserving this treatment to highly selected patients (without precipitating factor, or after failure of first choice treatment).