The Signs and Symptoms of Hepatic Encephalopath in Hospice
Introduction
Hepatic encephalopathy is defined as a spectrum of neuropsychiatric abnormalities in patients with liver dysfunction, after exclusion of brain disease.

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Signs of Hepatic Encephalopathy
- Flapping tremor or asterixis (early stages)
- Stupor (late stage)
- Coma (late stage)
Symptoms of Hepatic Encephalopathy
The following and should be documented:
- Decreased awareness of environment
- Sleep disturbance
- Depression
- Emotional lability
- Somnolence
- Slurred speech
- Obtundation
References
Warrell DA, Cox TA, Firth JD & Benz EJ, Oxford Textbook of Palliative Medicine, 4th ED. Oxford University Press, UK 2003.
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