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Neonatal encephalopathy (NE), previously known as neonatal hypoxic-ischemic encephalopathy (neonatal HIE or NHIE), is defined as a encephalopathy syndrome with signs and symptoms of abnormal neurological function, in the first few days of life in an infant born after 35 weeks of gestation.
Sarnat staging, Sarnat Classification or the Sarnat Grading Scale is a classification scale for hypoxic-ischaemic encephalopathy of the newborn (HIE), a syndrome caused by a lack of adequate oxygenation around the time of birth which manifests as altered consciousness, altered muscle tone, and seizures. [1]
Hypoxic-ischemic encephalopathy: This is the most common cause of seizures in the neonatal period, [39] causing approximately 33% of neonatal seizures. [4] The onset of seizure associated with it occurs within first 12 to 24 hrs of life. [citation needed] Delays in diagnosis may further increase the brain injury.
Infants who do give indications of stroke in the womb or shortly after birth commonly experience seizures. [3] When an infant has a seizure, they experience jerking in the face, legs, or arms, alongside delayed breathing. [4] Seizures are mostly caused by hypoxic-ischemic encephalopathy (HIE) or perinatal asphyxia. [34]
Hypoxic ischemic encephalopathy (HIE) is a condition that occurs when the entire brain is deprived of an adequate oxygen supply, but the deprivation is not total. While HIE is associated in most cases with oxygen deprivation in the neonate due to birth asphyxia , it can occur in all age groups, and is often a complication of cardiac arrest .
Perinatal asphyxia can be the cause of hypoxic ischemic encephalopathy or intraventricular hemorrhage, especially in preterm births. An infant with severe perinatal asphyxia usually has poor color , perfusion, responsiveness, muscle tone, and respiratory effort, as reflected in a low 5 minute Apgar score.
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An exaggerated Moro reflex can be seen in infants with severe brain damage that occurred in-utero, including microcephaly and hydranencephaly. [6] Exaggeration of the Moro reflex, manifesting either as low threshold or excessive clutching, often occurs in newborns with moderate hypoxic-ischemic encephalopathy.