Diagnosis and treatment of kernicterus

By Jason Brady

Baby in an incubator

In roughly 1 out of 100,000 cases, excessive levels of bilirubin in the blood can lead a baby to develop Kernicterus

The Impact of a Kernicterus Diagnosis

Should your baby suffer from kernicterus, there are a number of short and long-term effects they may face:

  • Displaying a poor awareness of the world around them, perhaps not responding to audio-visual stimuli.
  • Your child’s muscles may be abnormally floppy or ineffective.
  • You may experience difficulties in feeding your child.
  • As the condition develops your child may begin to experience seizures and show an arching of the neck and/or spine.
  • Kernicterus can lead to bilirubin encephalopathy; resulting in your baby’s head remaining abnormally small and leading to significant cognitive impairment.
  • Where excess bilirubin is allowed to damage the spinal cord and cause a spinal injury, kernicterus can be fatal.
  • Where treatment is not administered promptly, your baby may suffer brain injury leading to associated conditions such as cerebral palsy.
  • Your child may experience hearing loss, which can be mild to severe.
  • He or she may exhibit involuntary twitching or uncontrollable movements throughout the body.
  • Problems associated with maintaining eye contact or remaining focused on a particular area – children with kernicterus have been known to gaze upwards or to one side, rather than to maintain a steady forward focus.
  • Your child may experience learning difficulties.
  • Many children with kernicterus have also been known to experience dental development issues.

The presence and severity of symptoms can vary, often according to how quickly the condition is diagnosed and treated by medical staff. Where medical negligence can be shown to have contributed to or exacerbated the effects of kernicterus it can have a significant influence on your compensation claim.

Treatment of Kernicterus

Whilst it is true that the majority of cases of newborn jaundice do not require treatment, babies should always be monitored to ensure that symptoms do not persist beyond the usual 10-14 day period. Premature babies are at greater risk of developing kernicterus and warrant even closer supervision.

Where testing shows that your baby has abnormally high levels of bilirubin, two primary treatment methods could and should be employed to prevent Kernicterus:

  • Phototherapy: This is where a special form of light is shone on the baby’s skin, prompting the bilirubin system to change and become more easily broken down by the liver.
  • Performing an Exchange Transfusion: Where a matching donor can be sourced, a small amount of blood may be removed from your baby’s system and exchanged for an equivalent amount with lower levels of bilirubin.

Babies are known to respond well to these forms of treatment in the vast majority of cases, allowing for them to be discharged from the hospital within a few days. In light of this, cases of kernicterus are considered largely preventable – meaning the likelihood of medical negligence having occurred where it is discovered is elevated. This will likely have a bearing on any prospective compensation claim made by the families of babies who suffer from the condition.

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