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
Proper adjective Proper adjective In English orthography, the term proper adjective is sometimes applied to adjectives that take initial capital letters, and the term common adjective to those that do not. For example, a person from Boston is Bostonian. "Bostonian" is a proper adjective. These terms are used informally only; they are not used by grammarians or linguists. The term "proper noun" denotes a noun that, grammatically speaking, identifies a specific unique entity; for example, "England" is a proper noun, because it is a name for a specific country, whereas "dog" is not a proper noun; it is, rather, a "common noun"