In medicine 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.
Level of Consciousness
|
State 1 |
Stage 2 |
Stage 3 |
|
Hyperalert |
Lethargic or obtunded |
Stuporous |
Neuromuscular Control
|
State 1 |
Stage 2 |
Stage 3 |
Muscle tone |
Normal |
Mild hypotonia |
Flaccid |
Posture |
Mild distal flexion |
Strong distal flexion |
Intermittent decerebration |
Stretch reflexes |
Overactive |
Overactive |
Decreased or absent |
Segmental myoclonus |
Present |
Present |
Absent |
Complex Reflexes
|
State 1 |
Stage 2 |
Stage 3 |
Suck |
Weak |
Weak or absent |
Absent |
Moro |
Strong; low threshold |
Weak; incomplete; high threshold |
Absent |
Oculovestibular |
Normal |
Overactive |
Weak or absent |
Tonic neck |
Slight |
Strong |
Absent |
Autonomic Function
|
State 1 |
Stage 2 |
Stage 3 |
|
Generalized sympathetic |
Generalized parasympathetic |
Both systems depressed |
Pupils
|
State 1 |
Stage 2 |
Stage 3 |
|
Mydriasis |
Miosis |
Variable; often unequal; poor light reflex |
Heart Rate
|
State 1 |
Stage 2 |
Stage 3 |
|
Tachycardia |
Bradycardia |
Variable |
Bronchial and Salivary Secretions
|
State 1 |
Stage 2 |
Stage 3 |
|
Sparse |
Profuse |
Variable |
GI Motility
|
State 1 |
Stage 2 |
Stage 3 |
|
Normal or decreased |
Increased; diarrhea |
Variable |
Seizures
|
State 1 |
Stage 2 |
Stage 3 |
|
None |
Common; focal or multifocal |
Uncommon (excluding decerebration) |
EEG Findings
|
State 1 |
Stage 2 |
Stage 3 |
|
Normal (awake) |
Early: low-voltage continuous delta and theta Later: periodic pattern (awake) Seizures: focal 1-to 1-Hz spike-and-wave |
Early: periodic pattern with Isopotential phases Later: totally isopotential |
Duration
|
State 1 |
Stage 2 |
Stage 3 |
|
1-3 days |
2-14 |
Hours to weeks |
Details published by MedScape Reference