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Lim: Common Complications after Hypoxic-ischemic Encephalopathy
Review

Brain & Neurorehabilitation 2014; 7(1): 10-15.

Published online: 31 March 2014

DOI: https://doi.org/10.12786/bn.2014.7.1.10

Common Complications after Hypoxic-ischemic Encephalopathy

Seong Hoon Lim, M.D., Ph.D.

Department of Rehabilitation Medicine, School of Medicine, The Catholic University of Korea, Korea.

Correspondence to: Seong Hoon Lim, Department of Rehabilitation Medicine, School of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon 442-723, Korea. Tel: 031-249-7650, Fax: 031-251-4481, seonghoon@catholic.ac.kr

Copyright © 2014 Korean Society for Neurorehabilitation

Abstract

Hypoxic-ischemic encephalopathy (HIE) is one of the major disease for neuro-rehabilitation, as well as one of the important impairment. HIE typically shows global deterioration of brain function with relative preservation of brain stem reflexes, and topographic pattern of damage; the CA1 hippocampal cells, cerebellar Purkinje cells, neocortical neurons in layers 3, 5, 6 and basal ganglia. The characteristics of patho-mechanism including persistent vegetative state, seizure, autonomic dysfunction and secondary Parkinsonism are causative factors of several complications. Management of these complications sometimes curative, but more often re-adaptive and palliative. Understanding and proper rehabilitation of complications will be one of the most important therapeutic strategies for patients with HIE.

Keywords: autonomic dysfunction, hypoxic-ischemic encephalopathy, persistent vegetative state, seizure, secondary parkinsonism

Figures and Tables

Fig. 1
Rostral-caudal deterioration of brain function and the hypothetical relationship between duration of ischemia and resultingbrain damage.2
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Fig. 2
Evolution of brain and systemic pathophysiologic changes during status epilepticus.6,15 GABA: +-aminobutyric acid, NMDA: N-methyl-D-aspartate.
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Fig. 3
Sample status epilepticus treatment algorithm for adults.15 IV: intravenous, ED: emergency department, IM: intramuscular, O2: oxygen, HR: heart rate, BP: blood-pressure, EKG: electrocardiogram, CBC: complete blood count, BMP: basic metabolic profile, Ca: calcium, Mg: magnesium, PO4: phosphate, LFT: liver function test, ABG: arterial blood gas, AED: antiepilepticdrug, HCG: human chorionic gonadotropin, PE: phenytoin equivalent, EEG: electroencephalogram.
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Table 1
The EEG Findings Related with Poor Prognosis in HIE16
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Table 2
Theprognosis with the Five EEG Grades1
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Table 3
Features of Paroxysmal Sympathetic Hyperactivity and Mixed Automonichyperactivity19
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