Table 2

 Components and grading of encephalopathy in term newborns

Clinical Encephalopathy Score (range: 0–6)*
Encephalopathy signScore = 0Score = 1, if abnormal
    AlertnessAlertIrritable, limited responsiveness or coma
    ToneNormalHypotonia or hypertonia
    ReflexesNormalHyperreflexia or hyporeflexia
    Respiratory statusNormalRespiratory distress or support needed
    FeedingNormalGavage feeds or gastrostomy tube
    SeizuresNoneClinical seizure
Three clinical stages of encephalopathy†
FeatureStage 1Stage 2Stage 3
*Adapted from Miller et al.44
†Adapted from Sarnat and Sarnat.46
    Level of consciousnessHyperalertLethargic or obtundedStuporous
    Neuromuscular controlNormalMild hypotoniaFlaccid
    Complex reflexesWeakWeak or absentAbsent
    Autonomic functionSympatheticParasympatheticBoth depressed