Neonatal Encephalopathy: Beyond Hypoxic-Ischemic Encephalopathy.

Area of Science:

• Neonatology
• Pediatric Neurology
• Clinical Medicine

Background:

• Neonatal encephalopathy (NE) is a clinical syndrome of neurologic dysfunction in newborns.
• The term NE is a description of neurologic status, not indicative of etiology.
• Hypoxic-ischemic encephalopathy (HIE) is often incorrectly used as a substitute for NE, despite other causes existing.

Purpose of the Study:

• To differentiate NE from HIE.
• To expand the differential diagnosis of NE beyond HIE.
• To provide a comprehensive overview of NE evaluation, diagnosis, and treatment.

Main Methods:

• Literature review of NE and HIE.
• Discussion of epidemiology, clinical presentations, diagnostics, imaging, and therapeutics for various NE causes.
• Emphasis on distinguishing HIE from other etiologies.

Main Results:

• NE affects 2-6 per 1,000 term births; HIE accounts for approximately 1.5 per 1,000 term births.
• Differential diagnosis of NE includes infectious, vascular, epileptic, genetic/congenital, metabolic, and toxic causes.
• HIE should only be diagnosed when perinatal asphyxia is the primary cause.

Conclusions:

• Neonatologists and child neurologists must be familiar with the diverse causes of NE.
• Accurate diagnosis requires considering etiologies beyond HIE.
• This review aids in broadening the differential diagnosis and management of NE.