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	<id>https://idwiki.org/index.php?action=history&amp;feed=atom&amp;title=Hepatic_encephalopathy</id>
	<title>Hepatic encephalopathy - Revision history</title>
	<link rel="self" type="application/atom+xml" href="https://idwiki.org/index.php?action=history&amp;feed=atom&amp;title=Hepatic_encephalopathy"/>
	<link rel="alternate" type="text/html" href="https://idwiki.org/index.php?title=Hepatic_encephalopathy&amp;action=history"/>
	<updated>2026-05-13T02:35:15Z</updated>
	<subtitle>Revision history for this page on the wiki</subtitle>
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	<entry>
		<id>https://idwiki.org/index.php?title=Hepatic_encephalopathy&amp;diff=11038&amp;oldid=prev</id>
		<title>Aidan: /* Grading */</title>
		<link rel="alternate" type="text/html" href="https://idwiki.org/index.php?title=Hepatic_encephalopathy&amp;diff=11038&amp;oldid=prev"/>
		<updated>2025-03-09T13:42:36Z</updated>

		<summary type="html">&lt;p&gt;&lt;span class=&quot;autocomment&quot;&gt;Grading&lt;/span&gt;&lt;/p&gt;
&lt;table style=&quot;background-color: #fff; color: #202122;&quot; data-mw=&quot;interface&quot;&gt;
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				&lt;col class=&quot;diff-content&quot; /&gt;
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				&lt;td colspan=&quot;2&quot; style=&quot;background-color: #fff; color: #202122; text-align: center;&quot;&gt;← Older revision&lt;/td&gt;
				&lt;td colspan=&quot;2&quot; style=&quot;background-color: #fff; color: #202122; text-align: center;&quot;&gt;Revision as of 13:42, 9 March 2025&lt;/td&gt;
				&lt;/tr&gt;&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-lineno&quot;&gt;Line 4:&lt;/td&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-lineno&quot;&gt;Line 4:&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Normal consciousness, personality, neurological examination, and electroencephalogram&lt;/div&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Normal consciousness, personality, neurological examination, and electroencephalogram&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;* &#039;&#039;&#039;Grade 1:&#039;&#039;&#039; changes in behaviour with minimal change in level of consciousness&lt;/div&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;* &#039;&#039;&#039;Grade 1:&#039;&#039;&#039; changes in behaviour with minimal change in level of consciousness&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;−&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Restless, sleep disturbed, irritable/agitated, &lt;del style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;termor&lt;/del&gt;, impaired handwriting, 5 cps waves on EEG&lt;/div&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Restless, sleep disturbed, irritable/agitated, &lt;ins style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;tremor&lt;/ins&gt;, impaired handwriting, 5 cps waves on EEG&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;* &#039;&#039;&#039;Grade 2:&#039;&#039;&#039; gross disorientation, drowsiness, possibly asterixis, inappropriate behaviour&lt;/div&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;* &#039;&#039;&#039;Grade 2:&#039;&#039;&#039; gross disorientation, drowsiness, possibly asterixis, inappropriate behaviour&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Lethargic, time-disoriented, inappropriate, asterixis, ataxia, slow triphasic waves on EEG&lt;/div&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Lethargic, time-disoriented, inappropriate, asterixis, ataxia, slow triphasic waves on EEG&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;/table&gt;</summary>
		<author><name>Aidan</name></author>
	</entry>
	<entry>
		<id>https://idwiki.org/index.php?title=Hepatic_encephalopathy&amp;diff=8940&amp;oldid=prev</id>
		<title>Aidan at 18:01, 9 March 2022</title>
		<link rel="alternate" type="text/html" href="https://idwiki.org/index.php?title=Hepatic_encephalopathy&amp;diff=8940&amp;oldid=prev"/>
		<updated>2022-03-09T18:01:35Z</updated>

		<summary type="html">&lt;p&gt;&lt;/p&gt;
&lt;table style=&quot;background-color: #fff; color: #202122;&quot; data-mw=&quot;interface&quot;&gt;
				&lt;col class=&quot;diff-marker&quot; /&gt;
				&lt;col class=&quot;diff-content&quot; /&gt;
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				&lt;td colspan=&quot;2&quot; style=&quot;background-color: #fff; color: #202122; text-align: center;&quot;&gt;← Older revision&lt;/td&gt;
				&lt;td colspan=&quot;2&quot; style=&quot;background-color: #fff; color: #202122; text-align: center;&quot;&gt;Revision as of 18:01, 9 March 2022&lt;/td&gt;
				&lt;/tr&gt;&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-lineno&quot;&gt;Line 1:&lt;/td&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-lineno&quot;&gt;Line 1:&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;== Grading ==&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;br /&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;* &#039;&#039;&#039;Grade 0:&#039;&#039;&#039; no encephalopathy&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Normal consciousness, personality, neurological examination, and electroencephalogram&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;* &#039;&#039;&#039;Grade 1:&#039;&#039;&#039; changes in behaviour with minimal change in level of consciousness&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Restless, sleep disturbed, irritable/agitated, termor, impaired handwriting, 5 cps waves on EEG&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;* &#039;&#039;&#039;Grade 2:&#039;&#039;&#039; gross disorientation, drowsiness, possibly asterixis, inappropriate behaviour&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Lethargic, time-disoriented, inappropriate, asterixis, ataxia, slow triphasic waves on EEG&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;* &#039;&#039;&#039;Grade 3:&#039;&#039;&#039; marked confusion, incoherent speech, sleeping most of the time but arousable to vocal stimulus&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Somnolent, stuporous, place-disoriented, hyperactive reflexes, rigidity, slower waves on EEG&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;* &#039;&#039;&#039;Grade 4:&#039;&#039;&#039; comatose, unresponsive to pain, decorticate or decerebrate posturing&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;** Unrousable coma, no personality/behvaiour, decerebrate, slow 2-3 cps delta activity on EEG&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td colspan=&quot;2&quot; class=&quot;diff-empty diff-side-deleted&quot;&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;br /&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;== Investigations ==&lt;/div&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;== Investigations ==&lt;/div&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;tr&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;br /&gt;&lt;/td&gt;
  &lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;
  &lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;br /&gt;&lt;/td&gt;
&lt;/tr&gt;
&lt;/table&gt;</summary>
		<author><name>Aidan</name></author>
	</entry>
	<entry>
		<id>https://idwiki.org/index.php?title=Hepatic_encephalopathy&amp;diff=4247&amp;oldid=prev</id>
		<title>Maintenance script: Imported from text file</title>
		<link rel="alternate" type="text/html" href="https://idwiki.org/index.php?title=Hepatic_encephalopathy&amp;diff=4247&amp;oldid=prev"/>
		<updated>2020-07-04T01:17:37Z</updated>

		<summary type="html">&lt;p&gt;Imported from text file&lt;/p&gt;
&lt;p&gt;&lt;b&gt;New page&lt;/b&gt;&lt;/p&gt;&lt;div&gt;== Investigations ==&lt;br /&gt;
&lt;br /&gt;
* In general, discourage measuring serum ammonia&lt;br /&gt;
&lt;br /&gt;
== Management ==&lt;br /&gt;
&lt;br /&gt;
=== Acute ===&lt;br /&gt;
&lt;br /&gt;
* Lactulose&lt;br /&gt;
&lt;br /&gt;
=== Chronic prophylaxis ===&lt;br /&gt;
&lt;br /&gt;
* Lactulose&lt;br /&gt;
* Add-on: rifaximin&lt;br /&gt;
* Reassess adherence&lt;br /&gt;
* Assess for medications contributing to encephalopathy&lt;br /&gt;
&lt;br /&gt;
[[Category:Neurology]]&lt;br /&gt;
[[Category:Gastroenterology]]&lt;/div&gt;</summary>
		<author><name>Maintenance script</name></author>
	</entry>
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