Neonatal encephalopathy is the presence of clear neurological dysfunction in a newborn infant. It is usually caused by oxygen deprivation before or during birth, and it is important to evaluate infants for other potential causes, such as congenital diseases or drug reactions, because this can alter the course of treatment. Management of neonatal encephalopathy is focused on providing supportive care to the infant with periodic checkups to see how well the baby is recovering. Even if a baby seems to recover well, doctors usually recommend neurological follow up until at least 18 months of age.
A baby born with neonatal encephalopathy will have symptoms like slowed reflexes, poor muscle tone, seizures, and difficulty breathing. Poor feeding is also common and babies can have reduced heart rates. All of these issues are signs of central nervous system dysfunction, showing that the area of the brain responsible for regulating basic reflexes has suffered an injury. Usually the cause is hypoxia, or oxygen deprivation.
The services of a neurologist are usually recommended when doctors suspect neonatal encephalopathy. The doctor will order some medical imaging studies of the brain to learn more about what is going on and will also conduct a thorough physical exam and request bloodwork to check for other possible causes of neurological dysfunction. Over the course of follow-up appointments, the neurologist can determine the extent of the damage and provide recommendations for management and treatment, adjusting these as needed as the child grows.
Treatments for neonatal encephalopathy can include resuscitation if babies stop breathing or experience cardiac arrest, along with artificial ventilation to help babies who cannot breathe on their own. Sometimes, medications are helpful and babies may also benefit from gentle physical therapy. Studies by organizations like the American College of Obstetrics and Gynecology suggest that the patient outcome at around two weeks can be predictive of long-term outcomes.
People who experienced neonatal encephalopathy as infants can have permanent brain damage. This may result in a variety of issues, ranging from difficulty walking to severe learning disabilities. The specifics vary from case to case, and a thorough neurological workup is recommended, as is aggressive interventional care to provide children with access to physical and occupational therapy, as well as an education.
Legally, one concern with neonatal encephalopathy is establishing whether the hypoxia occurred before, during, or shortly after birth, and finding out who was responsible. If medical errors occurred, the doctors and hospital may be liable for expenses related to the child's care.