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)