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Kernicterus - Athetoid Cerebral Palsy


Kernicterus is the medical description of a specific form of brain damage resulting from excessive levels of bilirubin in the bloodstream which is one of the causes of athetoid cerebral palsy that can be responsible for hearing loss, visual distrubances and mental retardation. Bilirubin is a waste product produced by the breakdown of haemoglobin found in red blood cells which can, in high concentrations, cause jaundice and selectively damage the part of the brain known as the basal ganglia that has a crucial role in controlling motor movement. Some newborn babies produce too much bilirubin which builds up and causes jaundice making the skin and whites of the eyes turn yellow. Slight jaundice is very common in newborn babies and usually goes away by itself however a few babies suffer from very high levels of bilirubin in the blood stream which can cause kernicterus and subsequent brain damage.

Because of the risk of brain damage any sign of jaundice in babies that could lead to kernicterus should be carefully monitored. There is no absolute level of jaundice that is considered to be dangerous however intervention by medical practitioners usually takes place at a level of 20 milligrams of bilirubin per 100cc of blood. The warning signs of kernicterus may include:

  • yellow or orange skin tones
  • baby is not as alert and awake
  • increased sleepiness, so much that it is hard to wake the baby
  • high-pitched cry
  • weakness, limpness, or floppiness
  • poor sucking or nursing
  • baby's body is arched like a bow

Any baby with untreated jaundice is at risk of kernicterus however most babies with jaundice get better by themselves. It is normal for some red blood cells to die everyday and in newborns the liver may not be sufficiently developed to efficiently remove bilirubin. The yellow colur does not hurt the baby's skin, but bilirubin in high concentrations can lead to brain damage. If a babys skin is very yellow, then either phototherapy treatment or an exchange transfusion may be necessary to stabilize bilirubin levels and reduce the risk of kernicterus. There are certain recognised risk factors for kernicterus which include:

  • If the baby has a sibling that had jaundice then there is increased risk that the newborn will have jaundice.
  • A baby who has bruises at birth is likely to have jaundice. The healing of large bruises which involves the body processing red blood cells may cause high levels of bilirubin resulting in jaundice which can lead to kernicterus.
  • Babies born before 37 weeks may become jaundiced because the liver may be under developed and unable to process bilirubinin.
  • Babies who do not eat much are more likely to get jaundice.
  • A baby who is yellow in the first 24 hours of life may get dangerously jaundiced.
  • A baby born to an East Asian or Mediterranean family is at a higher risk of becoming very jaundiced.
  • There are other hereditary jaundice and consequent kernicterus risk factors.

Please consider our cerebral palsy information which contains an overview of this condition and its causes and if you believe that your child's condition is as a result of medical malpractice and you would like free advice on cerebral palsy settlements from a specialist attorney just complete the contact form and a member of The Association of Trial Lawyers of America will telephone to discuss your child's claim with no further obligation.