Pre-comatose stage of hepatic encephalopathy is mainly manifested by confusion and abnormal behavior.
Stage II of hepatic encephalopathy is also known as pre-comatose stage. Although there is no obvious comatose manifestation at this time, there will be confusion, drowsiness or daytime sleep and nighttime awakening, slurred speech, abnormal behavior and other manifestations, as well as hallucinations, fear, mania and other symptoms.
Physical examination reveals a decrease in orientation and comprehension of information about time, place and people. Some people may also have hyperreflexia, increased muscle tone, ankle clonus, and positive Babinski’s sign.
If the patient is instructed to stretch both upper limbs, rhythmic flexion and extension of the wrist joints can be observed, accompanied by a slow tremor, a phenomenon also known as fluttering tremor.
It is recommended to go to the hospital in time when the above mentioned manifestations occur.