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Table 3 WHC and clinical description of HE

From: The influence of shunting left/right portal vein branch on post-TIPS hepatic encephalopathy: a study protocol for multicenter randomized blinded controlled trial

WHC

ISHEN

Description

Minimal

Covert

Psychometric or neuropsychological alterations of tests exploring psychomotor speed/executive functions or neurophysiological alterations without clinical evidence of mental change

Grade I

 

Trivial lack of awareness

Euphoria or anxiety

Shortened attention span

Impairment of addition or subtraction

Altered sleep rhythm

Grade II

Overt

Lethargy or apathy

Disorientation for time

Obvious personality change

Inappropriate behavior

Dyspraxia

Asterixis

Grade III

 

Somnolence to semi stupor

Responsive to stimuli

Confused

Gross disorientation

Bizarre behavior

Grade IV

 

Coma