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Cirrhosis Communityarrow Cirrhosis Articlesarrow Staginging Encephalopathy
Staginging Encephalopathy Print E-mail
Written by mpmom   
08 August 2008

 

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 or

behavior. Asterixis absent.

Stage 1. Trivial lack of awareness. Shortened attention

span. Impaired addition or subtraction. Hypersomnia,

insomnia, or inversion of sleep pattern. Euphoria or

depression. Asterixis can be detected.

Stage 2. Lethargy or apathy. Disorientation. Inappropriate

behavior. Slurred speech. Obvious asterixis.

Stage 3. Gross disorientation. Bizarre behavior. Semistupor

to 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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