How mild is the outcome of mild neonatal encephalopathy?

Over 4 decades ago, Sarnat defined stage I, or mild, neonatal encephalopathy following fetal distress as a postanoxic state characterized by a hyperalert level of consciousness with normal muscle tone on exam, no clinical seizures, and a normal EEG (Arch Neurol 1976;33:696-705). In that report of just 21 patients >36 weeks' gestation with fetal distress and investigator-defined stage I mild to stage III severe encephalopathy, those neonates with <5 days in stage II moderate encephalopathy and a predominance of stage I findings were all developmentally normal subsequently at age 12 months.

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