Neonatal Encephalopathy Following Fetal Distress. A Clinical and Electroencephalographic Study

Arch Neurol. 1976 Oct;33(10):696-705. doi: 10.1001/archneur.1976.00500100030012.

Abstract

Twenty-one neonates of over 36 weeks' gestation suffered perinatal asphyxia but not chronic hypoxia. Three clinical stages of postanoxic encephalopathy were distinguished. Stage 1 lasted less than 24 hours and was characterized by hyperalertness, uninhibited Moro and stretch reflexes, sympathetic effects, and a normal electroencephalogram. Stage 2 was marked by obtundation, hypotonia, strong distal flexion, and multifocal seizures. The EEG showed a periodic pattern sometimes preceded by continuous delta activity. Infants in stage 3 were stuporous, flaccid, and brain stem and autonomic functions were suppressed. The EEG was isopotential or had infrequent periodic discharges. Infants who did not enter stage 3 and who had signs of stage 2 for less than five days appeared normal in later infancy. Persistence of stage 2 for more than seven days or failure of the EEG to revert to normal was associated with later neurologic impairment or death.

MeSH terms

  • Brain Diseases / etiology*
  • Brain Diseases / physiopathology
  • Consciousness
  • Female
  • Fetal Distress / complications*
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Newborn, Diseases / etiology*
  • Infant, Newborn, Diseases / physiopathology
  • Myoclonus / physiopathology
  • Parasympathetic Nervous System / physiopathology
  • Posture
  • Pregnancy
  • Prognosis
  • Seizures / physiopathology
  • Sleep
  • Sympathetic Nervous System / physiopathology
  • Time Factors
  • Wakefulness