Neurologic Examination
Step B. Infants eligible for hypothermia will have presence of moderate/severe encephalopathy defined as seizures OR presence of one or more signs in three of the six categories (level of consciousness, spontaneous activity, posture, tone, primitive reflexes and autonomic system).
Step B. Infants eligible for hypothermia will have presence of moderate/severe encephalopathy defined as seizures OR presence of one or more signs in three of the six categories (level of consciousness, spontaneous activity, posture, tone, primitive reflexes and autonomic system).
Category
1. Level of consciousness |
Normal |
Mild Encephalopathy |
Moderate Encephalopathy
Lethargic |
Severe Encephalopathy
Stupor/coma |
2. Spontaneous activity
|
Active
|
Decreased activity
|
No activity
|
3. Posture
|
Distal flexion, full extension
|
Decerebrate
|
4. Tone
|
Hypotonia (focal, general)
|
Flaccid
|
5. Primitive reflexes
Suck Moro |
Weak Incomplete |
Absent Absent |
6. Autonomic system
Pupils Heart rate Respirations |
Constricted Bradycardia Periodic breathing |
Skew deviation/dilated/non-reactive to light Variable HR Apnea |
The level of encephalopathy will be assigned based on which level of signs (moderate or severe) predominates among the 6 categories.
If moderate or severe signs are equally distributed, the designation is then based on the highest level in category #1: level of consciousness.
If moderate or severe signs are equally distributed, the designation is then based on the highest level in category #1: level of consciousness.