title: Bilirubin-Induced Neurological Dysfunction: A Clinico-Radiological-Neurophysiological Correlation in 30 Consecutive Children.
abstract: The clinical expression of bilirubin-induced neurological dysfunction varies according to severity and location of the disease. Definitions have been proposed to describe different bilirubin-induced neurological dysfunction subtypes. Our objective was to describe the severity and clinico-radiological-neurophysiological correlation in 30 consecutive children with bilirubin-induced neurological dysfunction seen over a period of 5 years. Thirty children exposed to acute neonatal bilirubin encephalopathy were included in the study. The mean peak total serum bilirubin level was 625 μmol/L (range 480-900 μmol/L). Acoustic brainstem responses were abnormal in 73% (n = 22). Pallidal hyperintensity was observed on magnetic resonance imaging in 20 children. Peak total serum bilirubin levels correlated with motor severity (P = .03). Children with severe motor impairment were likely to manifest severe auditory neuropathy (P < .01). We found that in a resource-constrained setting, classical kernicterus was the most common bilirubin-induced neurological dysfunction subtype, and the majority of children had abnormal acoustic brainstem responses and magnetic resonance imaging.
authors: Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
authors: Ronald
authors: R
authors: van Toorn
authors: Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
authors: Philip
authors: P
authors: Brink
authors: Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
authors: Johan
authors: J
authors: Smith
authors: Division of Radiodiagnosis, Stellenbosch University, Stellenbosch, South Africa.
authors: Christelle
authors: C
authors: Ackermann
authors: Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa regan@sun.ac.za.
authors: Regan
authors: R
authors: Solomons
mesh_terms: D000293:Adolescent; D001663:Bilirubin / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007647:Kernicterus / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D009422:Nervous System Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D015995:Prevalence; D012720:Severity of Illness Index; D013019:South Africa; D055815:Young Adult
chemical_list: D001663:Bilirubin
keywords: bilirubin-induced neurological dysfunction; kernicterus; magnetic resonance imaging