Improving the Diagnosis of Neonatal Encephalopathy: Validation of a Novel Encephalopathy Scale for Hypoxic-Ischemic Encephalopathy (HIE) using Electroencephalogram (EEG)

Abstract

BACKGROUND: Encephalopathy severity in neonates evaluated for therapeutic hypothermia (TH) has traditionally been determined by neurologic exam, sometimes alongside amplitude-integrated electroencephalogram (aEEG). The original 1976 report describing the progressive stages of encephalopathy (PMID 987769) led to modified versions of the Sarnat exam, which were utilized in randomized trials evaluating TH, with or without aEEG. However, there has been minimal validation of exam scores as measures of encephalopathy, distinct from outcome, and the relationship between neurologic exam, aEEG, and conventional EEG (cEEG) is not fully understood. Determining the best method to identify encephalopathy severity is critical to select neonates for TH. We developed a novel, simplified encephalopathy scale at …