General Special Needs

Sarnat Scale

scaleIn 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


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


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


State 1 Stage 2 Stage 3
1-3 days 2-14 Hours to weeks

Details published by MedScape Reference

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