Sarnat Staging for Hypoxic-Ischemic Encephalopathy (HIE)

Sarnat staging is used to classify the severity of hypoxic-ischemic encephalopathy in neonates based on clinical features and EEG findings.

It consists of three stages:
- Mild (Stage I)
- Moderate (Stage II)
- Severe (Stage III).

Feature	Stage I (Mild)	Stage II (Moderate)	Stage III (Severe)
Level of consciousness	Alert, hyperalert	Lethargic, obtunded	Stupor, coma
Muscle tone	Normal or mild hypertonia	Hypotonia	Flaccid
Deep Tendon Reflexes	Exaggerated	Weak or absent	Absent
Seizures	None	Common, often focal	Frequent, severe, refractory
EEG findings	Normal awake pattern, may show subtle abnormalities	Low voltage, slow activity, or seizures	Suppressed activity, isoelectric or burst suppression pattern

NOTE: Cause of exaggerated moro reflex- Stage 1 (early / mild) Hypoxic Ischemic Encephalopathy (HIE)

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