Neonatal encephalopathy is a broad clinical term that refers to abnormal brain function in a newborn. It’s usually recognized in the first days of life and is not a single diagnosis on its own.
Neonatal encephalopathy is a syndrome known for causing poor muscle tone, weak reflexes, an abnormal level of consciousness, breathing problems, seizures, and feeding problems. That means the baby may appear unusually sleepy, weak, floppy, difficult to arouse, irritable, or medically unstable shortly after birth.
The syndrome is caused in many different ways, but it should not be assumed that it was caused by a single event during labor.
Neonatal Encephalopathy Symptoms
Depending on the extent and cause of the brain dysfunction, symptoms can range from mild to severe. Those symptoms include:
- Unusual sleepiness or decreased responsiveness.
- Difficulty waking or staying alert.
- Poor muscle tone or a floppy body.
- Abnormally stiff muscles or unusual posturing.
- Weak or absent newborn reflexes.
- Poor feeding or weak suck.
- Trouble breathing or needing resuscitation/support after birth.
- Seizures or unusual jerking movements.
- Irritability or an abnormal cry.
- Low heart rate, poor color, or signs of broader medical distress.
Causes of Neonatal Encephalopathy
Many factors can cause neonatal encephalopathy, with one of the most recognized causes being hypoxic-ischemic injury. This is the result of the baby’s brain not getting enough oxygen or blood flow before, during, or after birth.
Hypoxic-ischemic encephalopathy is a brain injury that occurs when blood flow or oxygen to the brain is reduced around the time of birth.
However, oxygen deprivation is only one cause of neonatal encephalopathy. It can also be caused by acute obstetric events that affect the fetus or newborn. That can include chorioamnionitis, twin-to-twin transfusion, and placental abruption.
Infection, genetic disorder, intracranial hemorrhage, metabolic disturbances, and stroke are also part of the diagnosis.
Injuries or Conditions caused by neonatal encephalopathy
While some babies recover well from various forms of neonatal encephalopathy, many suffer from serious, long-term effects. That can include: vision or hearing issues, cerebral palsy, learning difficulties, feeding problems, developmental delay, epilepsy, and motor impairment.
The long-term effects of neonatal encephalopathy depend largely on the severity of the case, the underlying causes, and how quickly the baby received effective treatment.
How can medical malpractice cause neonatal encephalopathy?
Neonatal encephalopathy isn’t always preventable, and not every bad outcome is caused by medical malpractice. But that doesn’t mean there aren’t cases that are linked to preventable mistakes that were made before, during, and after birth.
Possible medical negligence issues may include:
- Failure to recognize fetal distress.
- Delayed response to abnormal fetal heart rate patterns.
- Delay in performing a necessary C-section.
- Improper neonatal resuscitation.
- Failure to maintain adequate oxygenation and ventilation after birth.
- Failure to diagnose and treat infection.
- Failure to recognize and respond to seizures.
- Failure to transfer the baby to a facility with appropriate NICU-level care.
For cases involving HIE, malpractice questions often focus on whether providers recognized warning signs early enough and acted quickly enough to reduce the duration of oxygen deprivation.
In other cases, issues can involve doctors missing a different cause altogether, such as bilirubin toxicity, intracranial hemorrhage, infection, or a metabolic emergency.
Because there are so many possible causes of neonatal encephalopathy, a careful and thorough review of medical records is essential when considering legal possibilities.
Neonatal Encephalopathy FAQs
What is the difference between neonatal encephalopathy and HIE?
Neonatal encephalopathy is a general term that describes when a newborn’s brain is not working normally. HIE is a specific type of neonatal encephalopathy that is caused by a lack of oxygen or blood flow around the time of birth.
While all cases of HIE are a form of neonatal encephalopathy, not all cases of neonatal encephalopathy are HIE. The difference between them is important because doctors must identify the precise cause in order to provide the right treatment. It also helps healthcare providers understand what may have gone wrong during pregnancy or delivery.
What role does therapeutic hypothermia play in HIE-related neonatal encephalopathy?
Therapeutic hypothermia is a specialized treatment used for some babies with moderate to severe HIE. The treatment involves carefully lowering the baby’s body temperature for a short period of time to reduce further brain injury after oxygen deprivation occurs.
To be effective, the treatment must begin within the first several hours after birth. If used correctly, therapeutic hypothermia can lower the risk of death or serious disability. However, the treatment can’t be used for all neonatal encephalopathy cases since not all cases are caused by oxygen deprivation.
Does neonatal encephalopathy always mean the baby was deprived of oxygen during birth?
No. Although oxygen deprivation is one possible cause, neonatal encephalopathy happens for a variety of reasons. That can include stroke, genetic conditions, infections, bleeding in the brain, and metabolic disorders.
Because so many possible causes and symptoms can lead to neonatal encephalopathy, healthcare staff need to carefully review the baby’s condition. That means using tests like blood work, brain imaging, and labor and delivery monitoring. Simply assuming that oxygen deprivation is the cause without a complete evaluation of the baby can lead to an incorrect diagnosis.
Can neonatal encephalopathy cause permanent disabilities?
Absolutely, and it only takes a moderate case to do so. While some babies recover easily, in moderate or serious cases, major long-term complications may arise.
That includes conditions such as cerebral palsy, epilepsy, developmental delays, learning disabilities, and problems with movement or coordination. The outcome largely depends on how severe the brain injury is, the cause, and how soon it was treated. That’s why an early diagnosis and timely medical care are so important to improving a child’s long-term outcome.
Can a delayed C-section contribute to neonatal encephalopathy?
In certain situations, yes. If the baby is showing signs of distress, such as issues with oxygen levels, cord issues, or placenta complications, a rapid delivery might be needed to prevent harm.
Any delays in responding to those warning signs may lead to the baby experiencing oxygen deprivation. That increases the risk of brain injury.
However, not every delayed C-section leads to neonatal encephalopathy. Each case is impacted by the timing and severity of the situation, as well as how the healthcare provider reacted.
When should parents investigate whether neonatal encephalopathy may have been caused by malpractice?
If your baby had serious complications such as needing emergency resuscitation, having seizures, being diagnosed with HIE, or requiring cooling treatment, you may want to inquire about possible medical malpractice. Other warning signs of possible malpractice include delayed emergency delivery or clear distress during labor that was not addressed quickly.
While these situations don’t necessarily mean medical malpractice occurred, they raise concerns worth reviewing.
Why should parents contact Weisser Law if they suspect medical malpractice contributed to neonatal encephalopathy?
If your child was diagnosed with neonatal encephalopathy, you deserve clear answers about what went wrong. In many cases, medical decisions made before, during, and after birth contributed to the issue, and medical mistakes aren’t always obvious.
You need a team on your side that knows what to look for, what is expected of medical providers, and what damages you may be entitled to.
Weisser Law is that team. We will review records, consult medical experts, and determine whether providers followed accepted standards of care. Contacting Weisser Law as soon as possible is the first step to holding those who hurt your child accountable.
Our team will fight tirelessly to ensure your family is compensated for not just the injury, but for any lifelong care, therapy, and medical needs your child may require for their life. Weisser Law offers free consultations and works on a contingency basis, meaning you don’t pay until we win.