How is hypoxic-ischemic encephalopathy (HIE) diagnosed?

Hypoxic-ischemic encephalopathy (HIE) is generally diagnosed by a physician once signs of oxygen deprivation (birth asphyxia) become evident. The diagnosis is typically based on a combination of medical history, physical and neurological exams, laboratory results, and neuroimaging. Many of these tests and studies assess brain injury severity and evaluate the status of the baby’s organ systems. Babies with neonatal seizures are usually evaluated for HIE.

Diagnosing HIE: Signs, Symptoms, and Tests

Signs and symptoms of hypoxic-ischemic encephalopathy (HIE) may include the following:

  • Resuscitation of the infant at birth
  • Seizures within the first 24 – 48 hours of delivery
  • Apgar Scoring System - Diagnosing Hypoxic-Ischemic Encephalopathy (HIE)

    Click to enlarge APGAR chart

    Low APGAR Scores for longer than 5 minutes. An APGAR score assesses the overall health of a newborn over the first few minutes of life. It considers things like the baby’s skin color/complexion, pulse rate, reflexes, muscle tone, and breathing.

  • Difficulty feeding, including the inability to latch, suck, or swallow.
  • Profound metabolic or mixed acidemia in an umbilical artery blood sample (the baby’s blood is acidic/has a low pH).
  • Coma
  • No brain stem reflexes (i.e., breathing problems and an abnormal response to light, and only blood pressure and heart function reflexes are working)
  • Hypotonia (low muscle tone)
  • Abnormal limpness
  • Multiple organ problems (e.g., the involvement of the lungs, liver, heart, and intestines)
  • Motor skills problems
  • Speech delays and difficulties

Tests and studies are conducted once medical professionals have observed signs and symptoms of HIE. These include:

  • CT scan: This test uses x-rays and computer software to make pictures of the baby’s brain.
  • MRI scan: This test uses magnetic waves to make pictures of structures inside the baby’s brain.
  • EKG (electrocardiogram): This test records heart activity by measuring electrical currents through the heart muscle.
  • Blood tests (arterial blood gases): These tests are used to help determine how well the baby is breathing, the pH of the blood (acidic, basic, or normal), and if any acidemia present is due to breathing or kidney problems.
  • Blood glucose levels: Excessively high glucose levels can lead to brain injury.
  • EEG (electroencephalogram): This test records the activity of the baby’s brain by measuring electrical currents through the brain.
  • Ultrasound: This test uses sound waves to evaluate blood flow in the vessels going to the brain or within the brain.
  • Evoked potential test: This is a neurophysiological test that evaluates the functioning of the baby’s brain by recording brain waves.
  • Echocardiogram: This test uses high-frequency sound waves to examine the size, shape, and motion of the baby’s heart.

The Importance of Diagnosing HIE Early Michigan hypoxic ischemic encephalopathy (HIE) lawyers discuss brain cooling treatment for HIE

If physicians promptly diagnose HIE in a newborn, there may still be time to prevent or limit permanent damage. There is a groundbreaking treatment for HIE called hypothermia therapy, also known as brain cooling, body cooling, and therapeutic hypothermia. Research shows that when hypothermia therapy is performed within six hours of the time the baby was deprived of oxygen, it can reduce the chance of death, as well as the extent and occurrence of permanent disability. If doctors fail to quickly recognize the signs of HIE and do not administer hypothermia therapy in time, the infant’s chances of developing serious, lifelong conditions is much higher. These conditions include:

 More Information on HIE

Video: Michigan Birth Injury Lawyers Discuss Hypoxic-Ischemic Encephalopathy (HIE)

In this video, Michigan birth injury lawyers Jesse Reiter and Rebecca Walsh discuss the causes of and treatments for HIE.

Legal Help

Award-Winning Michigan Hypoxic-Ischemic Encephalopathy (HIE) Lawyers

Sometimes a child will have signs and symptoms of HIE immediately after birth – especially if it was a complicated birth or if errors occurred in the delivery room. Other times, HIE may not be identified until years after a hypoxic event.  If your child was diagnosed with HIE, you should contact a law firm that focuses on this area.  The Michigan HIE lawyers at Reiter & Walsh ABC Law Centers have been helping children affected by HIE for decades, and are very skilled at handling the complex issues involved with HIE medical malpractice cases.

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