USE OF CLOCK AND STAR DRAWING, AS A MARKER OF NEUROPSYCHOLOGICAL ASSESSMENT IN THE GRADING OF HEPATIC ENCEPHALOPATHY AND COMPARE WITH WEST HAVEN CRITERIA AND PORTOSYSTEMIC ENCEPHALOPATHY SCORE AND INDEX

Abstract

Cirrhosis being usually irreversible is the end stage of many diseases affecting the liver. Hepatic Encephalopathy, the commonest complication of cirrhosis of liver, develops in 50- 70% of patients with cirrhosis, and its occurrence is a poor prognostic indicator. Constructional apraxia is a well recognized manifestation of hepatic encephalopathy. Grading of hepatic encephalopathy is necessary to assess the evolution of the condition and the response to the effects of therapy. Current hepatic encephalopathy grading tools are limited because of complexity or subjectivity. Hence a simple, objective, low cost, bedside method of assessing the grade of hepatic encephalopathy using clock and star drawing which depict the level of constructional apraxia may be useful.