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Back| Stage | Main Neuropsychiatric Manifestations | Neurological Signs | EEG |
|---|---|---|---|
| I - Prodromal Stage | Mild personality changes and behavioral disturbances | Often no asterixis | No significant abnormalities |
| II - Pre-Comatose Stage | Disorientation, sleep disturbances, and behavioral changes | Asterixis often present, tendon reflexes increased | Often presents abnormal slow waves (theta waves) |
| III - Stupor Stage | Stupor state, various neurological signs persistent or worsening, most of the time patient is in a stupor but can be awakened | Increased muscle tone, pyramidal signs (-); asterixis can be elicited if patient cooperates | Significant abnormal theta waves and triphasic waves appear |
| IV - Coma Stage | Complete loss of consciousness, cannot be awakened | In deep coma, asterixis cannot be elicited, reflexes disappear | Delta waves appear |
Explanation
Hepatic encephalopathy (HE) often accompanies cerebral edema and may present with intracranial hypertension; chronic HE is commonly seen in patients with cirrhosis and often has triggers, with recurrent stupor and coma being prominent manifestations. Patients with severe hepatic dysfunction often exhibit noticeable jaundice, bleeding tendency, and a liver odor, and are prone to various infections and hepatorenal syndrome, with direct causes of death often related to infections and respiratory failure.
