Role of fecal microbiota transplant in management of hepatic encephalopathy: Current trends and future directions

Table 2 Classification of hepatic encephalopathy based on American Association for Study of Liver Diseases[11]

Grade1		Explanation2	Suggested operational criteria3
Covert	Minimal	Tests measuring psychomotor speed, executive function, or neurophysiological abilities may change psychometrically or neuropsychological without showing any signs of a mental shift	A non-phenomenological abnormality on recognized psychometric or neuropsychological tests
	Grade 1	Trivial lack of awareness; Euphoria or anxiety; Shortened addition or subtraction	Despite being spatially and temporally oriented, this individual appears to have some cognitive/behavioral issues. decay concerning his clinical assessment that meets her standards, or to the carers
Overt	Grade 2	Lethargy or apathy; Gross disorientation; Obvious personality change; Inappropriate behavior	Disorientation with regard to time (at least three of the following are incorrect: day of the week, month, season, and year) plus/minus the other symptoms stated)
	Grade 3	Marked confusion; Somnolence to semi-stupor; Responsive to stimuli; Bizarre behavior	Disoriented also in terms of space (at least three of the incorrectly reported terms: nation, state or area, cities, location, plus/minus the other indicators)
	Grade 4	Comatose state; Unresponsive to pain; Decorticate or decerebrate posturing	Never react, not even with painful stimuli

¹Unimpaired.

²Absolutely no encephalopathy, no previous hepatic encephalopathy (HE) diagnosis.

³Examined and found to be normal.