Equine Neonatal Encephalopathy: Facts, Evidence, and Opinions

Neonatal encephalopathy (NE) and neonatal maladjustment syndrome (NMS) are terms used for newborn foals that develop noninfectious neurologic signs in the immediate postpartum period. Cerebral ischemia, hypoxia, and inflammation leading to neuronal and glial dysfunction and excitotoxicity are considered key mechanisms behind NE/NMS. Attention has been placed on endocrine and paracrine factors that alter brain cell function. Abnormal steroid concentrations (progestogens, neurosteroids) have been measured in critically ill and NE foals. In addition to supportive treatment, antimicrobials should be considered. Controversies regarding the pathophysiology, diagnosis, and treatment of NE and NMS will remain until controlled mechanistic and therapeutic studies are conducted.