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Changes in the globus pallidus in chronic kernicterus

Umesh C Parashari1, Ragini Singh, Rajesh Yadav

  • 1Department of Radio Diagnosis, C.S.M.M.U. (K.G.M.U.), Lucknow, UP, India.

Journal of Pediatric Neurosciences
|September 3, 2011
PubMed

Insights

Kernicterus, a severe form of newborn jaundice, can cause seizures and movement disorders in children. Brain MRI revealed characteristic changes in the globus pallidus, confirming the diagnosis and highlighting hearing loss risk.

Area of Science:

  • Neurology
  • Pediatrics
  • Radiology

Background:

  • Kernicterus, a preventable neurological complication of severe hyperbilirubinemia, can lead to long-term motor and auditory deficits.
  • Early diagnosis is crucial for managing kernicterus and mitigating its severe consequences in infants.

Observation:

  • A 1-year-old child presented with seizures and abnormal movements, prompting a diagnostic investigation.
  • Magnetic Resonance Imaging (MRI) of the brain was performed using a 1.5 T scanner.
  • Brain-stem evoked response examination was conducted due to the high risk of hearing impairment.

Findings:

  • Brain MRI revealed bilateral T2-weighted hyperintensities in the globus pallidus, indicative of bilirubin deposition.
  • No mass effect was observed on the MRI.
  • Brain-stem evoked response examination demonstrated severe bilateral sensorineural hearing loss.

Implications:

  • Isolated hyperintensities in the globus pallidus on T2-weighted MRI are a key imaging biomarker for diagnosing post-icteric bilirubin encephalopathy.
  • This case underscores the importance of neuroimaging in evaluating movement disorders and seizures in infants with a history of severe jaundice.
  • Prompt identification of kernicterus allows for targeted interventions and management of associated complications like hearing loss.

Keywords:
Brainbilirubinglobus pallidusinfantsmetabolism

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