The clinical course of hepatic encephalopathy is divided into 5 stages: latent stage, prodromal stage, pre-coma, lethargy and coma. 1. Latent stage (stage 0): there is no behavioral or personality abnormality, no neurological reflex abnormality, and only slight abnormality in intelligence or psychological test. 2. Prodromal stage (stage 1): there may be mild personality abnormalities, such as agitation, anxiety, indifference, anxiety, sleep inversion, etc., and may also be caused by mild fluttering tremor. 3. Pre-comatose period (stage 2): there may be behavioral abnormalities such as drowsiness, slurred speech, dysgraphia, and disheveled clothing, and there may be fluttering tremor, hyperreflexia of tendons, hypertonia, and so on. 4. Coma stage (stage 3): the manifestation of lethargy, can be awakened by the response, but also by hallucinations, confusion, etc., there are fluttering tremor, as well as tendon reflexes, hypertonia, Babinski’s sign is positive and other abnormalities of the pyramidal tract signs. 5. Coma stage (stage 4): the patient is comatose and cannot be awakened, but also cannot cooperate with the examination and cannot induce fluttering tremor (i.e., there will be wrist flexion and extension as well as coarse tremor when the arm is lifted flatly), and there are tendon reflexes and hypertonicity in shallow coma, which will be weakened or disappeared in deep coma. Hepatic encephalopathy is mostly secondary to liver diseases, causing metabolic disorders and central nervous system dysfunction, and the symptoms can be reversed at an early stage, but are difficult to be reversed at a later stage or even life-threatening. It is recommended that patients with hepatic encephalopathy should consult a doctor in time for treatment.