Atterbury et al listed criteria for semiquantitative grading of mental status in hepatic encephalopathy.
Patient selection: liver disease
Parameters:
(1) level of consciousness (LOC)
(2) orientation
(3) ability to perform tasks
(4) personality
Level of Consciousness
Orientation
Grade
trivial lack of awareness
oriented
1
lethargy or apathy
minimal disorientation to time or place
2
somnolent or in semistupor, responds to voice
disoriented to person, time and/or place (gross)
3
comatose, unrousable to voice or pain
NA
4
Ability to Perform Tasks
Personality
impaired addition, short attention span
euphoria, anxiety
impaired subtraction
suble changes, inappropriate behavior
unable
confusion
Ferenci et al prefer using the term minimal to subclinical for subtle neurological findings that may precede Grade 1.
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Specialty: Neurology, Gastroenterology, Toxicology
