Table 2.
West Haven criteria for grading hepatic encephalopathy. Copyright © [2011] Massachusetts Medical Society. All rights reserved.
| Grade 0 |
| Lack of detectable changes in personality or behavior |
| No asterixis |
| Grade 1 |
| Trivial lack of awareness, shortened attention span, sleep disturbance, and altered mood |
| Asterixis may be present |
| Grade 2 |
| Lethargy, disorientation to time, amnesia of recent events, impaired simple computations, inappropriate behavior, slurred speech |
| Asterixis is present |
| Grade 3 |
| Somnolence, confusion, disorientation to place, bizarre behavior, clonus, nystagmus, positive Babinski sign |
| Asterixis usually absent |
| Grade 4 |
| Coma and lack of verbal, eye, and oral response |