Thompson Score / HIE Severity Calculator
Free, instant Thompson score for neonatal encephalopathy and hypoxic-ischemic encephalopathy (HIE) from nine bedside clinical signs.
What Is the Thompson Score?
The Thompson score is a bedside assessment of neonatal encephalopathy and hypoxic-ischemic encephalopathy (HIE). It scores nine clinical signs—tone, consciousness, fits, posture, Moro reflex, grasp, suck, respiration, and fontanelle tension—to produce a total from 0 to 22.
Commonly reported interpretation bands are 0 normal, 1–10 mild, 11–14 moderate, and 15–22 severe neonatal encephalopathy. Serial assessments and the peak score provide more context than one result.
Instructions
Select the most appropriate score for each clinical sign below according to the baby's current neurological status. Once all signs are scored, click "Calculate Score" to get the total Thompson Score and an interpretation.
How to Interpret the Thompson Score
After you calculate the total (0–22), use these commonly reported severity bands. Serial scores and the peak score matter more than a single snapshot.
| Total score | Interpretation |
|---|---|
| 0 | Normal neurological examination on this score |
| 1–10 | Mild encephalopathy |
| 11–14 | Moderate encephalopathy |
| 15–22 | Severe encephalopathy |
This bedside score supports neurological assessment; it does not replace evaluation for therapeutic hypothermia, EEG/aEEG, neuroimaging, laboratory assessment, or local neonatal encephalopathy pathways.
Reference and Clinical Context
Use the Thompson score as one component of serial clinical assessment in a newborn with suspected neonatal encephalopathy. Management and prognostic decisions require the full clinical picture and local protocol.
- Thompson CM et al. The value of a scoring system for hypoxic ischaemic encephalopathy in predicting neurodevelopmental outcome. Acta Paediatr. 1997;86:757-761. Original description and outcome study of the nine-sign Thompson score.
- The Sarnat score for neonatal encephalopathy: looking back and moving forward. Pediatric Research. 2020. Review of neonatal encephalopathy scoring, clinical context, and limitations.
Frequently Asked Questions
What is the Thompson score used for?
It is a clinical score for describing the severity of neonatal encephalopathy from nine bedside neurological and respiratory signs.
What is the maximum Thompson score?
The maximum total is 22. Higher scores indicate more severe clinical encephalopathy.
How is the Thompson score interpreted?
Common severity bands are 0 normal, 1–10 mild, 11–14 moderate, and 15–22 severe. Serial scores and the peak score should be interpreted with the complete clinical assessment.
Can the Thompson score alone decide therapeutic hypothermia?
No. Cooling eligibility is time-sensitive and must follow local criteria using the full perinatal history, examination, laboratory findings, and neurological monitoring where available.