Neurodegenerative diseases: Neonatal Encephalopathy

Written by: Caroline Kim

September 14, 2024

The topic of this week’s post will be about Neonatal Encephalopathy, which affects 2-6 per 1000 births (Russ). As defined by Molloy, NE is a “clinical syndrome of disturbed neurologic function in the first week after birth in an infant born at or beyond 35 weeks of gestation, manifest by a subnormal level of consciousness or seizures, often accompanied by difficulty with initiating and maintaining respiration, and depression of tone and reflexes”. We’ll discuss the symptoms, causes, risks, and treatments in detail throughout today’s post. 

Severity of this condition is determined upon factors such as how long the brain is without oxygen flow, how much of the brain is impacted, and how the individual’s brain recovers (National Institute of Health). In most cases, this is caused by a lack of oxygen to the brain either during pregnancy or birth but can also be caused by infection in the mother’s uterus during pregnancy, a genetic disorder, or an intraventricular hemorrhage (Riley Children’s Hospital). While this condition directly affects the brain, the condition can affect the heart, lungs, liver, and other internal organs; symptoms that show right after birth include respiratory problems, a subnormal level of consciousness, seizures, and depressed reflexes (Riley Children’s Hospital). Symptoms later on could involve being highly alert, showing low signs of energy, not eating, trouble hearing, seizures, organ failures, and slow heart rates (Nationwide Children’s). 

Risk factors for NE include abnormally high/low blood pressure in the mother, heart problems in the baby, emergency c-sections, labor and delivery issues, and problems with the uterus (Cleveland Clinic Medical Professional). Additional risk factors as stated by the National Institute of Health include anemia in the fetus, internal bleeding by the mother or fetus, premature birth, trauma to the skull, and poor positioning of the baby during birth. Diagnosis for NE consists of blood tests, testing the umbilical cord/placenta, lumbar punctures, ultrasounds, EEGs, and MRIs. While there is no known cure for NE, treatments such as therapeutic hypothermia and supportive care are utilized; this could involve a cooling system for therapeutic hypothermia and speech/physical therapists for supportive cure (Nationwide Children’s). According to Nationwide Children’s Hospital, NE does predispose children to higher risks of developing other neurological conditions such as cerebral palsy, ADHD, epilepsy, and developmental disorders. 

Sources:

1. Molloy, Eleanor J., et al. “Neonatal Encephalopathy and Hypoxic–Ischemic Encephalopathy: Moving from Controversy to Consensus Definitions and Subclassification.” Nature News, Nature Publishing Group, 12 Aug. 2023, www.nature.com/articles/s41390-023-02775-z#:~:text=NE%20and%20hypoxic%E2%80%93ischemic%20encephalopathy,is%20a%20subgroup%20of%20NE. Accessed 13 Sept. 2024. 

2. Riley Children’s Hospital. “Neonatal Encephalopathy.” Riley Children’s Health, 1 Sept. 2024, www.rileychildrens.org/health-info/neonatal-encephalopathy#:~:text=Points%20to%20Remember-,Key%20Points%20to%20Remember,also%20affect%20other%20organ%20systems. Accessed 13 Sept. 2024. 

3. Nationwide Children’s. “Neonatal Hypoxic-Ischemic Encephalopathy.” Nationwide Children’s Hospital, 1 May 2022, www.nationwidechildrens.org/conditions/health-library/neonatal-hypoxic-ischemic-encephalopathy. Accessed 13 Sept. 2024. 

4. Russ JB, Simmons R, Glass HC. Neonatal Encephalopathy: Beyond Hypoxic-Ischemic Encephalopathy. Neoreviews. 2021 Mar;22(3):e148-e162. doi: 10.1542/neo.22-3-e148. PMID: 33649088.

5. Cleveleand Clinic Medical Professional. “What Is Hypoxic-Ischemic Encephalopathy (HIE)?” Cleveland Clinic, 1 May 2024, my.clevelandclinic.org/health/diseases/hypoxic-ischemic-encephalopathy-hie. Accessed 13 Sept. 2024. 

6. National Institute of Health. “Hypoxic Ischemic Encephalopathy | National Institute of Neurological Disorders and Stroke.” National Institute of Neurological Disorders and Stroke, 19 July 2024, www.ninds.nih.gov/health-information/disorders/hypoxic-ischemic-encephalopathy. Accessed 13 Sept. 2024.