Patients with MHE have deficits in attention and prospective memory which are cognitive domains that are important to activities such as driving. Sustaining attention is important for learning and remembering new information, for e.g. keeping the car within the lane while driving and paying attention to pedestrians and cyclists. Prospective memory involves both working memory (to formulate, initiate, and modify plans of action) and retrospective memory (to recall what needs to be done at a particular time or in response to an external cue), for instance, remembering the correct exit while driving on the highway. The act of driving requires the ability to sustain attention and utilize prospective memory under stressful conditions. Impairment in any of these areas may result in serious consequences for patient with chronic liver disease, such as cirrhosis. Indeed, some studies of cirrhotic patients have shown that those with MHE have a diminished ability to drive and significantly more motor vehicle crashes and traffic violations than those without MHE (Bajaj et al., 2007, 2009). The reasons behind this are thought to be not only the obvious cognitive deficits, but also a greater tendency to fatigue at the wheel and poor insight into the cognitive deficiencies (Kircheis et al., 2009). In fact, driving simulator tests and questionnaire surveys have shown that patients with MHE who have been diagnosed using the ICT have impaired navigational skills and significantly higher crash rates (Bajaj et al., 2008, 2009).