LHN - Define an Episode

Define an Episode of Hepatic Encephalopathy

Once you have identified patients with hepatic encephalopathy (HE), work with them and/or their caregivers to come up with a management plan to help reduce the risk of recurrence by monitoring for symptoms and identifying an episode of overt HE (OHE). If patients are monitored regularly, symptoms of an OHE episode can be addressed before a transition of care is needed.

An episode or occurrence in patients with OHE can be identified by testing/monitoring for the following symptoms:

Disorientation for time. Getting any 3 of the following wrong: day of the month, day of the week, month, season, or year
Lethargy or apathy
Obvious personality change
Inappropriate behavior
Dyspraxia
Asterixis
Somnolence to semistupor
Responsive to stimuli
Confusion
Gross disorientation
Bizarre behavior
Coma

Patients with a previous occurrence of OHE have a
40% risk of recurring OHE at 1 year.¹

Patients with recurrent HE have a
40% risk of another recurring within 6 months, despite lactulose treatment.¹

The LIVERHEALTHNOW tools in this section have been developed to help you recognize evidence of HE episodes so you can help reduce the risk of recurrence and even hospitalization. There are also tools to help patients and/or their caregivers monitor symptoms between medical visits.

You can add your organization logo to the resources and create favorite links of the tools.

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Provider Resources

Monitoring and Documenting Overt Hepatic Encephalopathy Episodes
Help Patients Set Goals Using Shared Decision Making
Counseling Your Hepatic Encephalopathy Patients About Driving

Patient Resources

Important Signs and Symptoms for Patients With Chronic Liver Disease
Prevent Another Attack for Overt Hepatic Encephalopathy
Importance of Taking Medication as Prescribed for Overt Hepatic Encephalopathy
Goal Setting When You Have Chronic Liver Disease
Living With Diabetes and Liver Disease
Setting Up Medical Alerts on Digital Devices

References

Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014;60(2):715-735.

Resources