Kernicterus

(Bilirubin Encephalopathy)

ByKevin C. Dysart, MD, Nemours/Alfred I. duPont Hospital for Children
Reviewed/Revised Mar 2021 | Modified Sept 2022
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Kernicterus is brain damage caused by unconjugated bilirubin deposition in basal ganglia and brain stem nuclei.

hyperbilirubinemiapreterm infants

Symptoms and Signs of Kernicterus

In preterm infants, kernicterus may not cause recognizable clinical symptoms or signs. Early symptoms of kernicterus in term infants are lethargy, poor feeding, and vomiting. Opisthotonos, oculogyric crisis, seizures, and death may follow. Kernicterus may result in intellectual disability, choreoathetoid cerebral palsy, sensorineural hearing loss, and paralysis of upward gaze later in childhood. It is unknown whether minor degrees of kernicterus can cause less severe neurologic impairment (eg, perceptual-motor problems, learning disorders).

Diagnosis of Kernicterus

  • Clinical evaluation

There is no reliable test to determine the presence of kernicterus, and the diagnosis is made presumptively. A definite diagnosis of kernicterus can be made only by autopsy.

Treatment of Kernicterus

  • Prevention of hyperbilirubinemia

There is no treatment once kernicterus develops; it must be prevented by treating hyperbilirubinemia.

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