Dubowitz L, Ricci D, Mercuri E. The Dubowitz neurological examination of the full-term newborn. Ment Retard Dev Disabil Res Rev. 2005;11(1):52-60.
This review explains how the HNNE examination is performed and how the examination can be used to identify infants with neurological abnormalities. The article also describes those clinical signs that can help to differentiate infants with peripheral neuromuscular disorders from those with central nervous system involvement. The correlation between clinical and imaging findings in infants with neonatal brain lesions is also reported. In addition, there is a section describing how and when to apply an optimality scoring system in a research setting.
Mercuri E, Ricci D, Romeo DM. Neurological and visual assessments in very and late low-risk preterm infants. Early Hum Dev. 2012 Mar;88 Suppl 1:S31-3.
This is an overview of the neurological and visual findings in preterm infants at different gestational ages, using the HNNE and the battery for visual assessment.
Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez J, Cioni G, Damiano D, et al. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA Pediatr. 2017;171(9):897-907.
In this systematic review of six systematic reviews and two evidence-based clinical guidelines, all with high methodological Quality Assessment of Diagnostic Accuracy Studies (QUADAS) ratings, the authors found that diagnosis of cerebral palsy can be accurately made before 6 months’ corrected age. Based on the findings, the authors recommend that before 5 months’ corrected age, magnetic resonance imaging (MRI) plus the General Movements Assessment or the Hammersmith Infant Neurological Examination (HINE) are used to predict cerebral palsy; after 5 months’ corrected age, MRI (where safe and feasible), the HINE and the Developmental Assessment of Young Children are recommended.