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.
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