Document Detail


Definition of the clinical spectrum of kernicterus and bilirubin-induced neurologic dysfunction (BIND).
MedLine Citation:
PMID:  15578034     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Kernicterus, currently used to describe both the neuropathology of bilirubin-induced brain injury and its associated clinical findings, is a complex syndrome. The neurobiology of kernicterus, including the determinants and mechanisms of neuronal injury, is discussed along with traditional and evolving definitions ranging from classical kernicterus with athetoid cerebral palsy, impaired upward gaze and deafness, to isolated conditions, for example, auditory neuropathy or dys-synchrony (AN/AD), and subtle bilirubin-induced neurological dysfunction (BIND). The clinical expression of BIND varies with location, severity, and time of assessment, influenced by the amount, duration and developmental age of exposure to excessive free bilirubin. Although total serum bilirubin (TSB) is important, kernicterus cannot be defined based solely on TSB. For study purposes kernicterus may be defined in term and near-term infants with TSB > or = 20 mg/dl using abnormal muscle tone on examination, auditory testing diagnostic of AN/AD, and magnetic resonance imaging showing bilateral lesions of globus pallidus+/-subthalamic nucleus.
Authors:
Steven M Shapiro
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  25     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-20     Completed Date:  2005-05-05     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  54-9     Citation Subset:  IM    
Affiliation:
Division of Child Neurology, Departments of Neurology and Pediatrics, Medical College of Virginia Campus, Virginia Commonwealth University Medical Center, Richmond, VA 33298, USA.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Basal Ganglia / pathology,  physiopathology
Evoked Potentials, Auditory, Brain Stem / physiology
Humans
Infant
Infant, Newborn
Kernicterus / diagnosis*,  etiology*,  physiopathology
Severity of Illness Index

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