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The clinical syndrome of bilirubin-induced neurologic dysfunction

Lois Johnson1, Vinod K Bhutani

  • 1Pennsylvania Center for Kernicterus, Philadelphia, PA, USA.

Seminars in Perinatology
|June 7, 2011
PubMed

Insights

Bilirubin-induced neurologic dysfunction (BIND) may affect infants with moderate hyperbilirubinemia, causing subtle neurodevelopmental issues. Early assessment tools are needed for at-risk infants.

Area of Science:

  • Neonatology
  • Neurodevelopmental Pediatrics
  • Pediatric Neurology

Background:

  • Bilirubin-induced neurologic dysfunction (BIND) is traditionally associated with severe hyperbilirubinemia.
  • Subtle neurodevelopmental deficits may occur in infants with less severe hyperbilirubinemia exposure.

Purpose of the Study:

  • To propose that BIND encompasses a spectrum of neurologic manifestations in vulnerable infants.
  • To highlight the need for improved assessment tools for BIND.

Main Methods:

  • Review of clinical manifestations of BIND.
  • Identification of confounding factors influencing BIND.
  • Proposal for development of assessment tools for BIND.

Main Results:

  • BIND may present with subtle processing disorders affecting visual-motor, auditory, speech, cognition, and language.
  • Factors like prematurity, hemolysis, and bilirubin-albumin binding influence BIND.
  • Current diagnostic criteria may underestimate the full spectrum of BIND.

Conclusions:

  • BIND represents a spectrum of neurodevelopmental issues in infants exposed to varying degrees of hyperbilirubinemia.
  • Multisensory processing disorders are key manifestations of BIND.
  • Development of specific assessment tools is crucial for early detection and surveillance of at-risk infants.

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