Neonatal encephalopathy: when the diagnosis is not hypoxic ischaemic encephalopathy

Neonatal encephalopathy (NE) presents as reduced consciousness, often with seizures, abnormal tone, feeding and respiratory difficulties. The most common cause is secondary to a hypoxic-ischaemic event. However, there are many important diagnoses that can also present as NE, so-called 'hypoxic ischaemic encephalopathy (HIE) mimics'. This paper, aimed at paediatric trainees, aims to describe clinical situations in which a diagnosis other than HIE should be suspected, the differential diagnoses to consider and appropriate investigations.