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