What is HE? (Hepatic Encephalopathy)

What are the symptoms of hepatic encephalopathy?

HE may be considered either “covert” or “overt”:

Covert hepatic encephalopathy symptoms are minimal and can go unnoticed, even by a doctor.

Overt hepatic encephalopathy symptoms are more noticeable to other people.

Your doctor may tell you what “Grade” of HE you or your loved one has. Minimal and Grade 1 is considered covert. Grades 2, 3 and 4 are overt hepatic encephalopathy.

Grade 2 is the least severe overt HE and grade 4 is the most severe overt HE.

HE symptoms outlined by Grade include:

Grade 1:

Lack of awareness
Euphoria
Depression or anxiety
Shortened attention span
Difficulty with addition or subtraction
Altered sleep patterns,
including insomnia

Grade 2:

Lack of energy or interest
Confused sense of date and time
Obvious personality change
Inappropriate behavior
Uncoordinated movements
Tremor or flapping of the wrists

Grade 3:

Sleepiness or stupor
Responds to stimuli
Confused sense of place,
where one is
Extreme disorientation

Grade 4:

Complete unresponsiveness (hepatic coma)

To help track your symptoms at home and talk to your doctor about your symptoms over time, complete this symptom tracker.

If you have liver disease, such as cirrhosis, and are experiencing any of these symptoms, talk to your doctor about the possibility of HE. Early diagnosis and treatment are key to help manage the disease state.

After someone starts to show HE symptoms or has an overt hepatic encephalopathy episode, they are at risk of having more overt episodes in the future. Hospitalizations may occur as a result of overt HE.

What is HE?

HEPATIC ENCEPHALOPATHY (HE) IS A COMPLICATION OF CIRRHOSIS, A SEVERE FORM OF LIVER DISEASE.

Why does HE develop?