The clinical stages of hepatic encephalopathy
| Stage | Mental state |
|---|---|
| I | Mild confusion, euphoria or depression, decreased attention, slowing of ability to perform mental tasks, untidiness, slurred speech, irritability, reversal of sleep rhythm |
| II | Drowsiness, lethargy, gross deficits in ability to perform mental tasks, obvious personality changes, inappropriate behaviour, intermittent disorientation (usually for time), lack of sphincter control |
| III | Somnolent but rousable, unable to perform mental tasks, persistent disorientation with respect to time and/or place, amnesia, occasional fits of rage, speech present but incoherent, pronounced confusion |
| IV | Coma, with (IVA) or without (IVB) response to painful stimuli |
From Adams and Foley13 with modifications.