West Haven Criteria for Hepatic Encephalopathy Grading
Grade 1 
 - Trivial lack of awareness 
 - Euphoria or anxiety 
 - Shortened attention span 
 - Impaired performance of addition 
Grade 2 
 - Lethargy or apathy 
 - Minimal disorientation for time or place 
 - Subtle personality change 
 - Inappropriate behavior 
 - Impaired performance of subtraction
Grade 3  
 - Somnolence to semi-stupor, but responsive to verbal stimuli 
 - Confusion 
 - Gross disorientation 
Grade 4 
 - Coma (unresponsive to verbal or noxious stimuli) 


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