Reversible neuropsychiatric disorder caused by liver dysfunction, leading to the accumulation of neurotoxins (mainly ammonia, NH₃) in the brain. It occurs in acute liver failure or as a complication of chronic liver disease (e.g., cirrhosis).
West Haven criteria for hepatic encephalopathy
- Minimal: Abnormal results on psychometric or neurophysiological testing without clinical manifestations
- Grade I: Changes in behavior, mild confusion, slurred speech, disordered sleep
- Grade II: Lethargy, moderate confusion
- Grade III: Marked confusion (stupor), incoherent speech, sleeping but arousable
- Grade IV: Coma, unresponsive to pain