How is hepatic encephalopathy diagnosed?
The mildest form of hepatic encephalopathy is difficult to detect clinically, but may be demonstrated on neuropsychological testing.
The first stage of hepatic encephalopathy is characterised by an inverted sleep pattern i.e. sleep by day and awake by night.
The second stage is marked by lethargy and personality changes.
The third stage is marked by worsened consfusion.
The fourth stage is marked by a progression to coma.
Coma and seizures represent the most advanced stages, cerebral oedema leads to death.