Table 2.

Sarnat and Sarnat staging [43] of moderate or severe HIE

Category	Moderate HIE	Severe HIE
1. Level of consciousness	Lethargy or obtunded	Stupor or Coma
2. Spontaneous activity	Decreased	Absent
3. Tone	Hypotonia	flaccidity
4. Posture	Distal flexion	Decerebrate state
5. Primitive reflexes
a. Suck	Weak or biting	Absent
b. Moro reflex	Incomplete	Absent
6. Autonomic nervous system
a. Pupils	Constricted	Deviated, dilated, or nonreactive to light
b. Heart rate	Bradycardia	Variable heart rate
c. Respirations	Periodic breathing	Apnoea
7. Seizures	Common, focal or multifocal	Absent or uncommon
8. EEG activity	Low voltage changing to seizure activity	Burst suppression to isoelectric

Presence of ≥1 of these signs in any 3 of the above 8 categories is required for diagnosis