Neonatal encephalopathies as classified by EEG-sleep criteria: severity and timing based on clinical/pathologic correlations.

Neonatal encephalopathies can be characterized in functional terms using electroencephalography. Severity of an encephalopathic state can also be estimated by electrographic interpretation independent of the time of disease process onset. Moderately or markedly abnormal electroencephalographic patterns on serial studies are highly correlated with neurologic sequelae in survivors. Electroencephalography is rarely pathognomonic or specific in determining when a condition initially occurred. However, electroencephalographic abnormalities are associated with different clinical situations, and brain lesions documented on neuroimaging or with postmortem neuropathologic examination are observed in infants with certain abnormal electrographic patterns. When interpreted in the context of history, clinical findings, and other laboratory information, the neurophysiologic studies augment the understanding of both the severity and timing of an encephalopathic state.