From:  How the gut-liver axis shapes hepatic encephalopathy: mechanistic and therapeutic perspectives

 West Haven criteria for the clinical grading of HE [17].

GradeClinical findings
Grade 1Unawareness, euphoria or anxiety, shortened attention span, and impairment of calculation ability.
Grade 2Lethargy or apathy, minimal disorientation for time or place, subtle personality change, and inappropriate behavior.
Grade 3Somnolence to stupor, responsiveness to stimuli, confusion, gross disorientation, and bizarre behavior.
Grade 4Coma.