Hepatic encephalopathy stage 4 can present as coma and inability to awaken. Hepatic encephalopathy stage 4 is the coma stage, this period can be manifested as coma, due to the inability to cooperate and thus unable to induce fluttering tremor, in shallow coma, hypertonia, tendon reflexes, in deep coma when all kinds of reflexes have disappeared, the muscle tone is reduced, the electroencephalogram is obviously abnormal. Hepatic encephalopathy stage 4 is a critical situation, you should immediately go to a regular hospital, under the guidance of a professional doctor to choose the appropriate treatment such as supplementing various vitamins, to ensure the supply of heat, as appropriate, the input of plasma, etc., in order to maximize the life expectancy and improve the quality of life.