Information on Kernicterus

Kernicterus is a form of brain damage caused by excessive jaundice. It also causes problems with vision and teeth and sometimes can result mental retardation. They are the basal ganglia, hippocampus, geniculate bodies and cranial nerve nuclei, especially the oculomotor, vestibular, and cochlear. The cerebellum can also be affected. In some newborn babies, the liver makes too much yellow pigment called bilirubin. Bilirubin is an orange-yellow bile pigment that is a byproduct of the natural breakdown of hemoglobin in red blood cells (hemolysis). This yellow coloring is called jaundice.

Jaundice generally seems primary on the face and then moves to the chest, stomach, arms, and legs as bilirubin stages get higher. The whites of the eyes can also look yellow. Jaundice can be harder to see in babies with darker skin color. Newborn jaundice affects 60% of newborns in the United States each year. Kernicterus may also be initiate in child as a symptom of Crigler-Najjar syndrome type I, a hereditary hyperbilirubinemia that is fatal within 18 months of life. Male infants have consistently higher levels of serum bilirubin than do female infants.

Among babies reported in the US kernicterus registry, 67% of the patients were male. The long-term effects of extreme jaundice on the newborn brain can range from subtle to severe. In some cases, infants with kernicterus may develop life-threatening complications. Several medications, such as the antibiotic co-trimoxazole may induce this disorder in the baby either when taken by the mother or given directly to the baby. Early treatment of jaundice or conditions that lead to jaundice may help prevent this complication. Many times, jaundice will go away without treatment. However, if treatment is required, the main treatment is a simple one.

Breast feeding augments levels of bilirubin but it may really be defensive for kernicterus. Babies are placed under special blue lights for a number of hours, or wrapped in a "bili-blanket". This is called phototherapy. It helps eliminate the bilirubin from the blood which can cause Kernicterus. The blue lights are hot and do not cause any harm to the baby. If the baby gets very, very jaundiced, blood transfusion to remove the extra bilirubin. This is called an "exchange transfusion."