2. Neuropsychiatric assessment scales.

Scale (Grippon 1988) used in Cadranel 1995; Barbaro 1998.
I	Euphoria or depression, mild confusion, slowness, disorder in sleep rhythm.
II	Drowsiness, inappropriate behaviour, accentuation of stage I.
III	Stupor; participant sleeps most of the time but is rousable; incoherent speech; marked confusion.
IVa	Coma, co‐ordinated response to painful stimuli.
IVb	Coma, hyperextension, and pronosupination after painful stimuli.
IVc	Coma, no response to painful stimuli.
V	Clinical decerebration.
Scale (Fitz 1998) used in Dursun 2003.
Subclinical	Normal examination with subtle changes in psychometric or Number Connection Tests.
I	Impaired attention, irritability, depression, or personality changes.
II	Drowsiness, behavioural changes, sleep disorders, and poor memory.
III	Confusion, disorientation, somnolence, and amnesia.
Scale (Jones 1988) used in Gyr 1996.
‐	Clinical assessment criteria consisted of the anamnestic criterion: disorders of sleep pattern (insomnia, hypersomnia, inversion of sleep rhythm) in combination with assessment of the level of consciousness (1 to 4 as described below). Score items weighted so major disturbances of consciousness (portal systemic encephalopathy stage III and IV) were associated with scores of ≥ 11. Portal systemic encephalopathy stage II defined as scores of 5 to 10 and stage I of 3 to 4.
1	Light disturbance of consciousness if ≥ 1 of following symptoms were present: drowsiness (tendency to fall asleep but wake up spontaneously or in response to normal voice or light), intermittent or permanent disorientation, retardation of ability to perform mental tasks (serial subtractions of sevens), mood disorder, inappropriate behaviour.
2	Somnolence (arousable to physical stimuli such as mild prodding or shaking only).
3	Stupor (localised motor response to pain).
4	Coma (unarousability, no or unlocalised motor reactions to painful stimuli).
Scale (no reference provided in paper) used in Van der Rijt 1995.
1	Presence of ≥ 2 of following abnormalities: inverted sleep pattern, disturbed memory, impaired calculation (serial sevens), slowness of speech, or flapping tremor.
2	Presence of ≥ 2 of following: lethargy, time disorientation, or flapping tremor.
3	Presence of ≥ 2 of following: a state in which person had to be stimulated repetitively to open his/her eyes or execute commands, disorientation in terms of place and disorientation with respect to person.
4	Coma.
Scale (Conn 1977) used in Zhu 1998.
1	Trivial lack of awareness, euphoria or anxiety, shortened attention span, impaired performance of addition or subtraction.
2	Lethargy or apathy, minimal disorientation for time or place, subtle personality change, inappropriate behaviour.
3	Somnolence to semistupor, but responsive to verbal stimuli; confusion; gross disorientation.
4	Coma.
Glasgow Coma Scale (CGS) (Teasdale 1974) used in Hermant 1991; Lacetti 2000; Dursun 2003; Li 2009.
Scores	Eye opening (E): 4 = spontaneous; 3 = to voice; 2 = to pain; 1 = none. Verbal response (V): 5 = normal conversation; 4 = disoriented conversation; 3 = words, but not coherent; 2 = no words, only sounds; 1 = none. Motor response (M): 6 = normal; 5 = localised to pain; 4 = withdraws to pain; 3 = decorticate posture (an abnormal posture that can include rigidity, clenched fists, legs held straight out, and arms bent inwards towards the body with wrists and fingers bend and held on chest); 2 = decerebrate (an abnormal posture that can include rigidity, arms and legs held straight out, toes pointed downwards, head and neck arched backwards); 1 = none.
Grading	Severe: GCS 3‐8 (minimum score 3). Moderate: GCS 9‐12. Mild: GCS 13‐15.
Modified Glasgow Coma Scale (Pappas 1983) used in Pomier‐Layrargues 1994; Barbaro 1998.
Scores	Verbal ability; Eye‐opening; Pupillary light reflex; Corneal reflex; Spontaneous eye movements; Oculocephalic reflex; Motor response; and Pattern of respiration.