Category Archives: Neurology

Tip 36: sucrose as analgesia

A Cochrane review showed that oral sucrose (with or without non-nutritive sucking) significantly reduced pain scores associated with heel lancing, venepuncture and IM injections but not ROP screening. The effects on extremely preterm infants or the long-term effects on any … Continue reading

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Tip 27b: HIE prognosis

Good prognostic features Stage I encephalopathy Absence of fits in first 24 hours Resolution of fits, off anticonvulsants, by 7 days. Ability to suck and feed by 7 days Poor prognostic features Stage II/III encephalopathy Encephalopathy >5 days Unreactive or … Continue reading

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Tip 27a: HIE prognosis

As a rough guide, the prognoses for different stages of HIE are: 1 (mild) – resolves in 24 – 48h.¬†Almost all normal on follow-up. 2 (moderate) – should resolve within 5 days. Majority normal on follow-up but poor outcome ranges … Continue reading

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Tip 26: hypoxic-ischaemic encephalopathy (HIE) stages

The Sarnat stages of encephalopathy are: 1 (mild) – hyperalert, normal tone, weak suck, normal CFM. 2 (moderate) – lethargic, hypotonic, brisk tendon reflexes, weak or absent suck, clinical or CFM seizures. 3 (severe) – comatose, flaccid, absent tendon & … Continue reading

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Tip 23: developmental follow-up for preterm infants

Enhanced developmental support and surveillance by a multidisciplinary team should be provided up to 2 years (corrected age) for children born preterm who: have a developmental problem, or are born <30/40, or are born 30 – 36/40 and have at … Continue reading

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Tip 251: cerebral palsy in preterm infants

Cerebral palsy prevalence increases with decreasing gestational age at birth. The following are independent risk factors for cerebral palsy in preterm infants: grade 3 or 4 intraventricular haemorrhage cystic periventricular leukomalacia neonatal sepsis bronchopulmonary dysplasia for which mechanical ventilation was … Continue reading

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Tip 246: cooling for HIE

A systematic review of several large multi-centre RCTs for therapeutic cooling to treat hypoxic-ischaemic encephalopathy included: Cool Cap (2005, 234 infants, head cooling only); NICHD (2005, 208 infants); TOBY (2009, 325 infants). It showed a¬†statistically significant reduction in the combined … Continue reading

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