Hepatic coma is also known as hepatic encephalopathy, and the four stages are prodromal stage, pre-comatose stage, somnolent stage and comatose stage. 1. Prodromal stage (stage 1): there are mild personality changes and mental abnormalities, such as indifference, forgetfulness or euphoria, agitation, anxiety, etc., and there may be mild fluttering tremor. 2. Pre-comatose period (stage 2): there may be neuropsychiatric symptoms such as drowsiness, slurred speech, dysgraphia, disorientation, etc., and at the same time, there will be tendon reflex hyperactivity, increased muscle tone, positive Babinski’s sign and other neurological reflexes, as well as fluttering tremor. 3. Coma stage (stage 3): the main manifestation is lethargy, but can wake up the response can be accompanied by confusion, hallucinations, etc., the abnormalities of neurological reflexes aggravated, there can be a positive pyramidal fasciculus sign, and fluttering-like tremor. 4. Coma stage (stage 4): the performance of coma, can not be awakened, and can not cooperate with the examination and difficult to elicit fluttering tremor. In shallow coma, tendon reflexes and muscle tone will be hyperactive, and in deep coma, tendon reflexes and muscle tone will be weakened or even disappeared. Early symptoms of hepatic coma can be reversed, but it is difficult to be reversed when it develops to a more advanced stage, and even life-threatening. It is recommended that patients with suspected hepatic encephalopathy should consult a doctor as soon as possible and follow the doctor’s instructions.