Abstract
A simple neurological screening examination should be performed on all term and preterm newborn infants, as part of the general medical examination. A full comprehensive neurological examination (NE) of the newborn infant should fulfill diagnostic and prognostic aims. As far as diagnosis is concerned, the NE needs to assess the severity of the acute (or subacute) brain dysfunction and to select those babies who may benefit from therapeutic hypothermia; the cooled newborn babies need to be assessed with serial NE during the first days after birth. As to the prognostic power of NE, repeated longitudinal assessment is needed in order to depict a developmental trajectory that better predicts the developmental outcome. The NE available for preterm and term newborn infants are discussed in relation to their peculiarities and strengths.
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References
Als H, Brazelton TB (1981) A new model of assessing the behavioral organization in preterm and fullterm infants: two case studies. J Am Acad Child Psychiatry 20:239–263
Als H, Lester BM, Tronick Z, Brazelton T (1982) Manual for the assessment of preterm infants’ behavior (APIB). In: Fitzgerald HE, Lester BM, Yogman MW (eds) Theory and research in behavioral pediatrics, vol 1. Plenum Press, New York, pp 65–132
Als H, Butler S, Kosta S, McAnulty G (2005) The Assessment of Preterm Infants’ Behavior (APIB): furthering the understanding and measurement of neurodevelopmental competence in preterm and full-term infants. Ment Retard Dev Disabil Res Rev 11:94–102
Amiel-Tison C (1978) A method for neurological evaluation within the first year of life: experience with full-term newborn infants with birth injury. Ciba Found Symp 59:107–137
Amiel-Tison C, Grenier A (1980) Évaluation neurologique du nouveau – né et du nourrisson. Masson, Paris
Azzopardi DV, Strohm B, Edwards AD, Dyet L, Halliday HL, Juszczak E et al (2009) Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med 361:1349–1358
Brazelton TB (1973) Neonatal behavioural assessment scale. In: Clinics in developmental medicine, no. 50. Spastics International Medical Publication/William Medical Books/JB Lippincott, London/Philadelphia
Cioni G, Ferrari F, Prechtl HF (1989) Posture and spontaneous motility in fullterm infants. Early Hum Dev 18:247–262
Cioni G, Ferrari F, Einspieler C et al (1997) Comparison between observation of spontaneous movements and neurologic examination in preterm infants. J Pediatr 130:704–711
Coleman MB, Glass P, Brown J, Kadom N, Tsuchida T, Scafidi J et al (2013) Neonatal neurobehavioral abnormalities and MRI brain injury in encephalopathic newborns treated with hypothermia. Early Hum Dev 89:733–737
De Vries LS, Cowan FM (2009) Evolving understanding of hypoxic-ischemic encephalopathy in the term infant. Semin Pediatr Neurol 16:216–225
Dubowitz LM, Dubowitz V (1981) The neurological assessment of the preterm and full-term newborn infant. Spastic International Medical Publications/William Heinemann Medical Books, London
Dubowitz LMS, Dubowitz V, Mercuri E (1998a) The neurological assessment of the preterm and full-term newborn infant. Textbook of clinics in developmental medicine. Mc Keith Press, Cambridge
Dubowitz LM, Mercuri E, Dubowitz V (1998b) An optimality score for the neurologic examination of the term newborn. J Pediatr 133:406–416
Eicher DJ, Wagner CL, Katikaneni LP, Hulsey TC, Bass WT, Kaufman DA et al (2005a) Moderate hypothermia in neonatal encephalopathy: safety outcomes. Pediatr Neurol 32:18–24
Eicher DJ, Wagner CL, Katikaneni LP, Hulsey TC, Bass WT, Kaufman DA et al (2005b) Moderate hypothermia in neonatal encephalopathy: efficacy outcomes. Pediatr Neurol 32:11–17
Einspieler C, Prechtl HF, Bos A et al (2004) Prechtl’s method on the qualitative assessment of general movements in preterm, term and young infants. Mac Keith Press, London
Fenichel GM (1983) Hypoxic-ischemic encephalopathy in the newborn. Arch Neurol 40:261–266
Ferrari F, Cioni G, Prechtl HF (1990) Qualitative changes of general movements in preterm infants with brain lesions. Early Hum Dev 23:193–231
Ferrari F, Cioni G, Einspieler C et al (2002) Cramped synchronized general movements in preterm infants as an early marker for cerebral palsy. Arch Pediatr Adolesc Med 156:460–467
Ferrari F, Todeschini A, Guidotti I, Martinez-Biarge M, Roversi MF, Berardi A et al (2011) General movements in full-term infants with perinatal asphyxia are related to basal ganglia and thalamic lesions. J Pediatr 158:904–911
Finer NN, Robertson CM, Richards RT et al (1981) Hypoxic-ischemic encephalopathy in term neonates: perinatal factors and outcome. J Pediatr 98:112–117
Gluckman PD, Wyatt JS, Azzopardi D, Ballard R, Edwards AD, Ferriero DM et al (2005) Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet 365:663–670
Gosselin J, Gahagan S, Amiel-Tison C (2005) The Amiel-Tison neurological assessment at term: conceptual and methodological continuity in the course of follow-up. Ment Retard Dev Disabil Res Rev 11:34–51
Jacobs SE, Morley CJ, Inder TE, Stewart MJ, Smith KR, McNamara PJ et al (2011) Whole-body hypothermia for term and near-term newborns with hypoxic-ischemic encephalopathy: a randomized controlled trial. Arch Pediatr Adolesc Med 165:692–700
Levene ML, Kornberg J, Williams TH (1985) The incidence and severity of post-asphyxial encephalopathy in full-term infants. Early Hum Dev 11:21–26
Miller SP, Latal B, Clark H, Barnwell A, Glidden D, Barkovich AJ et al (2004) Clinical signs predict 30-month neurodevelopmental outcome after neonatal encephalopathy. Am J Obstet Gynecol 190:93–99
Noble Y, Boyd R (2012) Neonatal assessments for the preterm infant up to 4 months corrected age: a systematic review. Develop Med Child Neur 54:129–139
Prechtl HF (1974) The behavioural states of the newborn infant. Brain Res 76:185–212
Prechtl HFR (1977) The neurological examination of the full-term newborn infant, 2nd revised edn. Heinemann, London
Prechtl HFR (1990) Qualitative changes of spontaneous movements in fetus and preterm infants are a marker of neurological dysfunction. Early Hum Dev 23:151–158
Prechtl HFR, Dijkstra J (1960) Neurological diagnosis of cerebral injury in the newborn. In: ten Berge BS (ed) Prenatal care. Noordhof, Groningen
Prechtl HF, Hopkins B (1986) Developmental transformations of spontaneous movements in early infancy. Early Hum Dev 14:233–238
Roodenburg PJ, Wladimiroff JW, van Es A, Prechtl HF (1991) Classification and quantitative aspects of fetal movements during the second half of normal pregnancy. Early Hum Dev 25:19–35
Rutherford M, Ramenghi LA, Edwards AD, Brocklehurst P, Halliday H, Levene M et al (2010) Assessment of brain tissue injury after moderate hypothermia in neonates with hypoxic-ischaemic encephalopathy: a nested substudy of a randomised controlled trial. Lancet Neurol 9:39–45
Saint-Anne Dargassies S (1955) Méthode d’examen neurologique du nouveau-né. Études Néonatales 3:101–123
Sarnat HB, Sarnat MS (1976) Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol 33:696–705
Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF et al (2005) Whole body hypothermia for neonates with hypoxic ischemic encephalopathy. N Engl J Med 353(1574):1584
Shankaran S, Laptook AR, Tyson JE, Ehrenkranz RA, Bann CM, Das A et al (2012a) Evolution of encephalopathy during whole body hypothermia for neonatal hypoxic-ischemic encephalopathy. J Pediatr 160:567–572
Shankaran S, Barnes PD, Hintz SR, Laptook AR, Zaterka-Baxter KM, McDonald SA et al (2012b) Brain injury following trial of hypothermia for neonatal hypoxic-ischaemic encephalopathy. Arch Dis Child Fetal Neonatal Ed 97:F398–F404
Simbruner G, Mittal RA, Rohlmann F, Muche R, neo.nEURO.network Trial Participants (2010) Systemic hypothermia after neonatal encephalopathy: outcomes of neo.nEURO.Network RCT. Pediatrics 126:e771–e778
Thompson CM, Puterman AS, Linley LL, Hann FM, van der Elst CW, Molteno CD et al (1997) The value of a scoring system for hypoxic ischaemic encephalopathy in predicting neurodevelopmental outcome. Acta Paediatr 86:757–761
Volpe JJ (2008) Neurological evaluation. In: Volpe JJ (ed) Neurology of the newborn, 5th edn. WB Saunders, Philadelphia
Zhou WH, Cheng GQ, Shao XM, Liu XZ, Shan RB, Zhuang DY et al (2010) Selective head cooling with mild systemic hypothermia after neonatal hypoxic-ischemic encephalopathy: a multicenter randomized controlled trial in China. J Pediatr 157:367–372
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Ferrari, F. et al. (2018). Neurological Examination of the Newborn Infant. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-319-29489-6_267
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DOI: https://doi.org/10.1007/978-3-319-29489-6_267
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