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| Staginging Encephalopathy |
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| Written by mpmom | |
| 08 August 2008 | |
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In patients with cirrhosis and overt encephalopathy, two staging classifications have been used for patients with HE.
1. The West Haven criteria of altered mental state in HE (20) (numerous studies have employed variations of these criteria). Stage 0. Lack of detectable changes in personality orbehavior. Asterixis absent. Stage 1. Trivial lack of awareness. Shortened attentionspan. Impaired addition or subtraction. Hypersomnia, insomnia, or inversion of sleep pattern. Euphoria or depression. Asterixis can be detected. Stage 2. Lethargy or apathy. Disorientation. Inappropriatebehavior. Slurred speech. Obvious asterixis. Stage 3. Gross disorientation. Bizarre behavior. Semistuporto stupor. Asterixis generally absent. Stage 4. Coma.2. Evaluation of the level of consciousness with the Glasgow Scale (21) (Table 1): although the Glasgow coma scale has not been rigorously evaluated in patients with HE, its widespread use in structural and metabolic disorders of brain function justifies its application in acute and chronic liver disease. AJG – July, 2001 Hepatic Encephalopathy 1969 |
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