Hypoxic-Ischemic Encephalopathy

[prasag]

What are the symptoms of moderate Hypoxic-Ischemic Encephalopathy in a baby of 2 month old?
What is expected with regard to his growth?

[prasag]

Dear Doc Yao Sun,

Thank you for your reply.My baby doesnt have grasp reflex.His moro reflex are fine.He gasps a lot while feeding.I think he has difficulty ion coordinating suck swallow and breathe....Does this mean poor feeding?
The doctors say--"Serious brain disorder is recognized around cortex and infracortical material alba as well as many parts with liquefaction sacculation.  Compare to this, disorders on basal ganglia and thalamus are mild."
What does this mean?
Regarding EEG they say--"Findings on EEG has improved and right before the discharge, it showed basic wave based on θ wave, and sharp wave was occasionally seen on left center side of the head."
What does this mean?
My baby is to be put on Phenobarbital drug for 1 year. Does this have any sideeffect?

The doctors havnt reffered to any special services...they say we have to wait and watch till the baby is 4 months old.
This waiting is a torture for us.We sense that we are wasting time by waiting instead of acting on from now itself to stimulate him.Can you suggest anything for us?

Thank you
Rasa

[Yao Sun, MD, PhD]

Hypoxic-Ischemic Encephalopathy (HIE, injury to the brain from decreased oxygen or blood flow) that is evident at the time of birth can lead to more lasting effects, depending upon the degree of injury.  In the milder cases, the baby may fully recover and go on to have normal development.  In more severe cases, the baby might have problems with muscle tone, motor activity, or have a delay in achieving developmental milestones.  These may manifest many ways in the first few months, including lethargy, irritability, poor feeding, and decreased growth.

Methods of assessing the degree of injury include physical exam, developmental testing, electrical functional testing such as the EEG (electroencephalograph), and imaging studies such as MRI.

When we discuss HIE with parents, we talk about the "risk" for long term neurodevelopmental problems.  This is because a baby's brain is still growing and making new connections, and the degree of long lasting injury is unpredictable.  Some babies have far fewer problems than one would predict based on the initial severity of their injury, although there are a few that also do the opposite.

Your baby may have already been referred for special services such as Physical and Occupational Therapy.  Generally speaking, these services are a real benefit for optimizing your baby's development, and practicing the prescribed exercises at home can be beneficial for both the baby and the parents.