Sarnat staging

Sarnat staging
Synonyms	Sarnat Classification
Purpose	classification for hypoxic-ischaemic encephalopathy of newborn

Sarnat staging, Sarnat Classification or the Sarnat Grading Scale is a classification scale for hypoxic-ischaemic encephalopathy of the newborn (HIE), a syndrome caused by a lack of adequate oxygenation around the time of birth which manifests as altered consciousness, altered muscle tone, and seizures.^[1] HIE is graded based on the infant's clinical presentation, examination findings, the presence of seizures and the duration of illness. Sarnat staging is used alongside electroencephalogram findings to provide information about the prognosis for the infant. Mild HIE, according to the scale, usually has a normal outcome, whereas in severe HIE the mortality rate is 75%, and 80% of survivors have neurological sequelae.^[2]

UK Resuscitation Council guidelines on newborn life support recommend that a baby who received significant resuscitation at birth and who goes on to show signs of encephalopathy should be assessed by Sarnat Staging between 24 and 48 hours from birth.^[3]

Staging

	Grade I Mild	Grade II Moderate	Grade III Severe
Alertness	Hyperalert	Lethargy	Coma
Muscle tone	Normal or increased	Hypotonic	Flaccid
Seizures	None	Frequent	Uncommon
Pupils	Dilated, reactive	Small, reactive	Variable, fixed
Respiration	Regular	Periodic	Apnoea
Duration	< 24 Hours	2 - 14 Days	Weeks

Adapted from ^[2]

References

^ Sarnat H, Sarnat M. Neonatal encaphalopathy following fetal distress. Arch Neurol. 33:695 - 705. 1976.
^ ^a ^b Gardiner M, Eisen S, Murphy C. Training in paediatrics: the essential curriculum. Oxford University Press, Oxford 2009.
^ Newborn Life Support: Third Edition. Resuscitation Council (UK), London 2011.

Diseases of the nervous system, primarily CNS

Inflammation

Brain	Encephalitis Viral encephalitis Herpesviral encephalitis Limbic encephalitis Encephalitis lethargica Cavernous sinus thrombosis Brain abscess Amoebic
Brain and spinal cord	Encephalomyelitis Acute disseminated Meningitis Meningoencephalitis

Brain/
encephalopathy

Degenerative

Extrapyramidal and movement disorders	Basal ganglia disease Parkinsonism PD Postencephalitic NMS NBIA PKAN Tauopathy PSP Striatonigral degeneration Hemiballismus HD OA Dyskinesia Dystonia Status dystonicus Spasmodic torticollis Meige's Blepharospasm Athetosis Chorea Choreoathetosis Myoclonus Myoclonic epilepsy Akathisia Tremor Essential tremor Intention tremor Restless legs Stiff-person
Dementia	Tauopathy Alzheimer's Early-onset Primary progressive aphasia Frontotemporal dementia/Frontotemporal lobar degeneration Pick's Lewy bodies dementia Posterior cortical atrophy Creutzfeldt–Jakob disease Vascular dementia
Mitochondrial disease	Leigh syndrome

Demyelinating

Autoimmune
Inflammatory
Multiple sclerosis
For more detailed coverage, see Template:Demyelinating diseases of CNS

Episodic/
paroxysmal

Seizures and epilepsy	Focal Generalised Status epilepticus For more detailed coverage, see Template:Epilepsy
Headache	Migraine Cluster Tension For more detailed coverage, see Template:Headache
Cerebrovascular	TIA Stroke For more detailed coverage, see Template:Cerebrovascular diseases
Other	Sleep disorders For more detailed coverage, see Template:Sleep