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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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