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Table 2 Sarnat and Sarnat staging [43] of moderate or severe HIE

From: Impact of Erythropoietin in the management of Hypoxic Ischaemic Encephalopathy in resource-constrained settings: protocol for a randomized control trial

CategoryModerate HIESevere HIE
1. Level of consciousnessLethargy or obtundedStupor or Coma
2. Spontaneous activityDecreasedAbsent
3. ToneHypotoniaflaccidity
4. PostureDistal flexionDecerebrate state
5. Primitive reflexes
 a. SuckWeak or bitingAbsent
 b. Moro reflexIncompleteAbsent
6. Autonomic nervous system
 a. PupilsConstrictedDeviated, dilated, or nonreactive to light
 b. Heart rateBradycardiaVariable heart rate
 c. RespirationsPeriodic breathingApnoea
7. SeizuresCommon, focal or multifocalAbsent or uncommon
8. EEG activityLow voltage changing to seizure activityBurst suppression to isoelectric
  1. Presence of ≥1 of these signs in any 3 of the above 8 categories is required for diagnosis