Hypoxic Ischemic Encephalopathy

Question 1

Clinical pic of Hypoxic Ischemic emcephalopathy

Answer 1

Ø Mild: infant is irritable, staring look, hyperventilation,
hypertonia , excessive response to stimulation
ØModerate: Hypotonic, lethargic , abnormal movements
and cannot feed, seizures
ØSevere: comatosed, no normal movement, abnormal
tone , refractory seizures, multiorgan failure

Question 2

Score used for assessment of Hypoxic ischemic encephalopathy

Answer 2

Thompson score

Question 3

Prognosis of hypoxic ischemic encephalopathy

Answer 3

Mild: complete recovery
• Moderate HIE: with good response to treatment and
normal clinical picture by 2 weeks :good prognosis. If
persistent abnormality : bad prognosis
• Severe HIE: mortality of 30–40%, over 80% have
neurodevelopmental disabilities among survivors
without cooling (Cooling improves prognosis but still
residual damage is common)
• If magnetic resonance imaging (MRI) of the brain at 5–
14 days in a term infant shows significant
abnormalities, here is a high risk of later cerebral palsy

Question 4

Timing of therapeutic hypothermia in hyloxic ischemic encephalopathy

Answer 4

Within 6 hrs of birth

Question 5

Management of hypoxic ischemic encephalopathy

Answer 5

SUPPORT / HYPOTHERMIA
• Close monitoring
• Respiratory support
• Anticonvulsants to control seizures
• Fluid balance (fluid restriction to prevent brain oedema,
whilst monitoring urine output and kidney function)
• Management of hypotension : volume and inotrope
• Proper glycemic and electrolyte control
• Therapeutic hypothermia when indicated