Staging and Clinical Features of Acute Hepatic Encephalopathy

In this article, we will discuss the Staging and Clinical Features of Acute Hepatic Encephalopathy. So, let’s get started.

Stage

  • Grade 0 (subclinical or minimal)
  • Cerebral features: Only minimal change in memory, concentration and intellectual function. Unfit to drive
  • Asterixis (tremors): Absent
  • EEG: Normal
  • Grade 1 (mild)
  • Cerebral features: Confusion, mood changes, slurred speech, disordered sleep
  • Asterixis (tremors): Can be present or absent
  • EEG: Triphasic slow (5 cycles/sec waves)
  • Grade 2 (moderate)
  • Cerebral features: Lethargy, drowsy but arousable, confusion, behavioural disturbances
  • Asterixis (tremors): Present
  • EEG: Triphasic waves
  • Grade 3 (severe)
  • Cerebral features: Marked confusion, incoherent speech, sleepy but arousable
  • Asterixis (tremors): Present
  • EEG: Triphasic waves
  • Grade 4 (coma)
  • Cerebral features: Coma, initially responsive to noxious stimuli, later non-responsive
  • Asterixis (tremors): Absent
  • EEG: Delta waves
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