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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

Category Moderate HIE Severe HIE
1. Level of consciousness Lethargy or obtunded Stupor or Coma
2. Spontaneous activity Decreased Absent
3. Tone Hypotonia flaccidity
4. Posture Distal flexion Decerebrate state
5. Primitive reflexes
 a. Suck Weak or biting Absent
 b. Moro reflex Incomplete Absent
6. Autonomic nervous system
 a. Pupils Constricted Deviated, dilated, or nonreactive to light
 b. Heart rate Bradycardia Variable heart rate
 c. Respirations Periodic breathing Apnoea
7. Seizures Common, focal or multifocal Absent or uncommon
8. EEG activity Low voltage changing to seizure activity Burst suppression to isoelectric
  1. Presence of ≥1 of these signs in any 3 of the above 8 categories is required for diagnosis