Answer 4 Grade 2. Hepatic encephalopathy can be graded as follows2: Grade 0: Normal mental status. Asterixis absent. Grade 1: Mild confusion. Asterixis can be detected. Grade 2: Lethargy with inappropriate behavior. Obvious asterixis. Grade 3: Somnolent with incomprehensible speech and marked confusion Grade 4: Coma 2 Blei AT, Cordoba J. Hepatic encephalopathy. Practice Parameters of the American College of Gastroenterology. Am J Gastroenterol 2001;96:1968-1976. Click here to return to the questions

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