Table 1.

West Haven Criteria for altered mental state in hepatic encephalopathy

STAGEDESCRIPTION
Grade I

  • Trivial lack of awareness

  • Euphoria or anxiety

  • Shortened attention span

  • Impairment of addition or subtraction

  • Altered sleep rhythm

Grade II

  • Lethargy or apathy

  • Disorientation for time

  • Obvious personality change

  • Inappropriate behaviour

  • Dyspraxia

  • Asterixis

Grade III

  • Somnolence or semistupor

  • Responsive to stimuli

  • Confused

  • Gross disorientation

  • Bizarre behaviour

Grade IV

  • Coma

  • Data from Vilstrup et al.6