Which sign indicates early hepatic encephalopathy under the West Haven criteria?

Which sign indicates early hepatic encephalopathy under the West Haven criteria?

• A. Disorientation only at night
• B. Agitation and loss of coordination
• C. Subtle changes in personality and mentation
• D. Stupor

Answer: (C)

In hepatic encephalopathy, the earliest changes come from mild brain dysfunction that affects thinking and behavior rather than clear confusion. Subtle changes in personality and mentation reflect this initial stage, when a person may seem irritable, have reduced attention, or show slight mood or behavior shifts while still being oriented and responsive. As the condition progresses, disorientation for time or place and noticeable personality changes become more evident, followed by agitation or poor coordination, and ultimately stupor or coma in more advanced stages. So, spotting those subtle personality and mentation changes is the best sign of the early stage of hepatic encephalopathy.

In hepatic encephalopathy, the earliest changes come from mild brain dysfunction that affects thinking and behavior rather than clear confusion. Subtle changes in personality and mentation reflect this initial stage, when a person may seem irritable, have reduced attention, or show slight mood or behavior shifts while still being oriented and responsive. As the condition progresses, disorientation for time or place and noticeable personality changes become more evident, followed by agitation or poor coordination, and ultimately stupor or coma in more advanced stages. So, spotting those subtle personality and mentation changes is the best sign of the early stage of hepatic encephalopathy.