Hepatic Encephelopathy
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West Haven criteria for grading hepatic encephalopathy
  • Grade 1: Trivial lack of awareness. Impaired attention span. Altered sleep, euphoria or depression. Mild asterixis may be present.
  • Grade 2: Lethargy or apathy. Disorientation. Inappropriate behavior. Slurred speech. Asterixis.
  • Grade 3: Gross disorientation. Bizarre behavior. Semi-stupor. Asterixis absent.
  • Grade 4: Coma (unresponsive to verbal or noxious stimuli)

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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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