Hepatic encephalopathy get a liver transplant, the risk of death is less than 30% over the subsequent five years. The condition has been described since at least 1860. The mildest form of hepatic encephalopathy is difficult to detect clinically, but may be demonstrated on neuropsychological testing. It is experienced as forgetfulness, mild confusion, and irritability. The first stage of hepatic encephalopathy is characterised by an inverted sleep-wake pattern (sleeping by day, being awake at night). The second stage is marked by lethargy and personality changes. The third stage is marked by worsened confusion. The fourth stage is marked by a progression to
Scotch (adjective) ma Scotch blue bell." Scotch (adjective) Scotch is an adjective meaning "of Scotland". The modern usage in Scotland is Scottish or Scots, and the word "Scotch" is only applied to specific products, mostly food or drink, such as Scotch whisky, Scotch pie, Scotch broth, and Scotch eggs. "Scotch" applied to people is widely considered pejorative in Scotland, reflecting old Anglo-Scottish antagonisms, but it is still occasionally used in England and Ireland, though the usage is considered old-fashioned. The verb "to scotch" is unrelated to the adjective. It derives from Anglo-French "escocher" meaning "to notch, nick", from "coche", "a notch, groove",