TY - JOUR
AU - Sarnat, Margaret S.
AB - 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. References 1. Plum F, Posner J: Diagnosis of Stupor and Coma , ed 2. Philadelphia, FA Davis Publishing Co, 1974. 2. Cheek DB, Malinek M, Fraillon JM: Plasma adrenalin and noradrenalin in the neonatal period, and infants with respiratory distress syndrome and placental insufficiency . Pediatrics 31:374-381, 1963. 3. Holden KR, Young RB, Piland JH, et al: Plasma pressors in the normal and stressed newborn infant . Pediatrics 49:495-503, 1972. 4. Stern L, Ledue J, Lind J: Hypoxia as a stimulus to catecholamine excretion in the newborn infant: II. Effect of exposure to 10% oxygen . Acta Paediatr Scand 53:13-17, 1964.Crossref 5. Harris RJ: Plasma nonesterified fatty acid and blood glucose levels in healthy and hypoxemic newborn infants . J Pediatr 84:578-584, 1974.Crossref 6. Girard JR, Zeghal N: Adrenal catecholamine content in fetal and newborn rats . Biol Neonate 26:205-213, 1975.Crossref 7. Saling E: Foetal and Neonatal Hypoxia in Relation to Clinical Obstetric Practice . Baltimore, Williams & Wilkins Co, 1968, pp 121-124. 8. Hammacher K, Huster KA, Bokelmann J, et al: Foetal heart frequency and perinatal condition of the foetus and newborn . Gynaecologia 166:349-360, 1968. 9. Hon EH: An Atlas of Fetal Heart Rate Patterns . New Haven, Conn, Harty Press, 1968. 10. Condorelli S, Scarpelli M: Fetal breathing: Induction in utero and effects of vagotomy and barbiturates . J Pediatr 88:94-101, 1976.Crossref 11. Dreyfus-Brisac C, Larroche JC: Discontinuous EEGs in premature and full-term neonates: Electro-anatomo-clinical correlations, abstracted . Electroencephalogr Clin Neurophysiol 32:575, 1972. 12. Engel RCH: Abnormal Electroencephalograms in the Neonatal Period . Springfield, Ill, Charles C Thomas Publisher, 1975. 13. Pampiglione G: Electroencephalographic studies after cardiopulmonary arrest . Proc R Soc Med 55:653-657, 1962. 14. Hockaday JM, Potts F, Epstein E, et al: Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest . Electroencephalogr Clin Neurophysiol 18:575-586, 1965.Crossref 15. Pampiglione G: Post-anoxic encephalopathies in children, abstracted . Electroencephalogr Clin Neurophysiol 32:574, 1972. 16. Prior PF: The EEG in Acute Cerebral Anoxia . Amsterdam, Excerpta Medica, 1973. 17. Samson Dollfus D: L'electroencephalogramme du prematuré jusqu' à l'âge de trois mois et du nouveau-né a terme, thesis. Paris, 1955. 18. Dreyfus-Brisac C, Fischgold H, Samson Dollfus D, et al: Vielle, sommeil et reactivite sensorielle chez le prematuré et le nouveau-né: Activité electrique cérébrale du nourrisson . Electroencephalogr Clin Neurophysiol 6( (suppl) ):418-440, 1956. 19. Dreyfus-Brisac C, Flescher J, Plassart E: L'electroencephalogramme: Critére d'âge conceptionnel du nouveau-né a terme et prematuré . Biol Neonate 4:154, 1962.Crossref 20. Rose AL, Lombroso CT: Neonatal seizure states: A study of clinical, pathological, and electroencephalographic features of 137 full-term babies with long-term follow-up . Pediatrics 45:404-425, 1970. 21. Huttenlocher PR: Development of cortical neuronal activity in the neonatal kitten . Exp Neurol 17:247-262, 1967.Crossref 22. Purpura DP: Synaptogenesis in mammalian cortex: Problems and perspectives , in Sterman MB, McGinty DJ, Adinolfi AM (eds): Brain Development and Behavior . New York, Academic Press Inc, 1971, pp 23-41. 23. Monod N, Pajot N, Guidasci S: The neonatal EEG: Statistical studies and prognostic value in full-term and pre-term babies . Electroencephalogr Clin Neurophysiol 32:529-544, 1972.Crossref 24. Mann LI, Prichard JW, Symmes D: EEG, ECG, and acid-base observations during acute fetal hypoxia . Am J Obstet Gynecol 106:39-51, 1970.
TI - Neonatal Encephalopathy Following Fetal Distress: A Clinical and Electroencephalographic Study
JO - Archives of Neurology
DO - 10.1001/archneur.1976.00500100030012
DA - 1976-10-01
UR - https://www.deepdyve.com/lp/american-medical-association/neonatal-encephalopathy-following-fetal-distress-a-clinical-and-scE0sbYafD
SP - 696
EP - 705
VL - 33
IS - 10
DP - DeepDyve
ER -