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