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Neonatal encephalopathy (NE) is a syndrome that can occur in newborn babies in which neurological function is disturbed. The most frequent cause of NE is lack of oxygen to the baby at some point during pregnancy or birth.
When oxygen deprivation causes NE, the condition may be referred to as hypoxic ischemic encephalopathy (HIE).
Lack of oxygen causes damage to the brain, but it can also affect other internal organs. The heart, lungs, kidneys, liver and gastrointestinal system may all experience complications as a result of low oxygen. Babies who experience NE and survive are at high risk to go on to have permanent brain injury or cerebral palsy, but immediate treatment can improve outcomes.
In some cases, NE can be caused by other factors such as:
A newborn with neonatal encephalopathy may experience the following immediately after birth:
Immediately after birth, the doctor will perform a physical exam on your newborn. If your baby shows signs of NE, he or she will be transferred to the neonatal intensive care unit (NICU) for specialized care.
If your baby is delivered in a hospital that does not have NICU capabilities, the mobile NeuroNICU transport service at Riley at IU Health can be dispatched to bring your baby to our NeuroNICU where he or she will receive the most advanced care, with therapeutic treatments provided in transit.
Newborns who experience NE are immediately treated with specialized neurology equipment from the NeuroNICU, a unique care program within the neonatal intensive care unit. Specialists from the NeuroNICU can bring portable technology into any baby’s room and make it a neurocritical care room without having to move the baby. As part of the NeuroNICU, a neurophysiologist and pediatric neurologist are on-site 24 hours a day to provide immediate neurological care for babies with NE.
Upon delivery, babies with NE are immediately provided with breathing assistance through intubation and mechanical ventilation. Fluids, electrolytes and medicines are provided intravenously through an IV. Your baby may also have a urinary catheter inserted, and doctors will perform blood tests to check for additional health concerns like liver or kidney problems.
If fluids and ventilation are not enough to bring your baby's neurological function back to normal, additional treatments may be necessary. These may include:
Once your baby is ready for an imaging study, he or she will receive a magnetic resonance imaging (MRI) scan of the brain. An MRI scan is required before going home.
Many babies who have had NE have an increased risk of going on to develop at least some neurological or developmental problems. You and your baby will work with a multidisciplinary team of occupational therapists, physical therapists, speech therapists and pediatric neurologists for comprehensive follow-up care.
The following websites provide additional information about neonatal encephalopathy.
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