Abstract
Neonatal encephalopathy (NE) is associated with high mortality and morbidity. Factors predisposing to NE can be antenatal, perinatal, or a combination of both. Antenatal maternal factors, familial factors, genetic predisposition, hypoxic ischemic encephalopathy, infections, placental abnormalities, thrombophilia, coagulation defects, and metabolic disorders all have been implicated in the pathogenesis of NE. At present, therapeutic hypothermia is the only treatment available, regardless of etiology. Recognizing the etiology of NE involved can also guide investigations such as metabolic and sepsis workups to ensure optimal management. Understanding the etiology of NE may allow the development of targeted adjunctive therapies related to the underlying mechanism and develop preventative strategies.
Highlights
Neonatal encephalopathy (NE) is a complex disease of the newborn characterized by an altered level of consciousness, seizures, poor tone, an inability to initiate or maintain respiration [1] and is associated with multi organ dysfunction [2]
On the contrary some authors state that hypoxic ischemic encephalopathy (HIE) is the cause of NE in 50 to 80% of cases based on clinical, EEG and MRI criteria [1]
CA was associated with lower risk of brain injury and poor cognitive outcome when compared to non-CA in neonates with NE (n = 258) only 20 neonates had histological evidence of CA
Summary
Neonatal encephalopathy (NE) is a complex disease of the newborn characterized by an altered level of consciousness, seizures, poor tone, an inability to initiate or maintain respiration [1] and is associated with multi organ dysfunction [2]. NE can result from a wide variety of causes and is a clinical term that does not specify etiology. There are multiple causes of NE such as hypoxic ischemic encephalopathy (HIE), perinatal infections, placental abnormalities, metabolic disorders, coagulopathies and neonatal vascular stroke (Figure 1). It is difficult to prove the presence of cerebral hypoxic ischemia apart from in animal models and particular cases of neonatal stroke. On the contrary some authors state that HIE is the cause of NE in 50 to 80% of cases based on clinical, EEG and MRI criteria [1].
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