Clinical features of hepatic encephalopathy in adults

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Clinical features of hepatic encephalopathy in adults

Stagesofhepaticencephalopathy

0 2 3
Normal

Hypersomnia,insomniaorinversionofsleeppattern
Slowresponses
Lethargy
Minimaldisorientation
Somnolence
Contusion
Stateofconsciousness
semi-scupor

Coma

Subtlyimpairedcomputations
Shortenedattentionspan
ossoftime
Grosslyimpaired
Lossorplace
Inabilitytocompute
Intellectualfunction
Lossofself
•Nointellect

Exaggerationofnormalbehavior
cuphoriaordepression

Irritabilitv
creasedinhibiti
vertchangeinpersonalicycompucarone
Anxietyorapatnv
Inaobropriatebenavior

Personality-behavior BParanoiaoranger
ĸасе

•Nopersonality-
behavior
Metabolictremor
Muscularincoordination
Asterixis
Impairedhandwritina

Slurredspeech
Ataxia
Hypoactiveandhyperactivereflexes
Nystagmus
Neuromuscularabnormalities Babinskiclonus
Rigidity
Dilatedpupils
•Opisthotonus
Coma

Diagram depicting the grade of hepatic encephalopathy in adults and the clinical
features associated with advancing stages.

Data from: Conn HO, Lieberthal MM. The hepatic coma syndromes and lactulose. Lippincott Williams
& Wilkins, Baltimore 1979.

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