The neurotoxicity of bilirubin

Recent clinical and research findings on kernicterus and bilirubin toxicity are reviewed. Bilirubin binds to cell membranes and appears to interfere with the metabolism, depolarization, and transmitter functions of neurons. The neurobehavioral and clinical findings associated with bilirubin encephalopathy and low bilirubin kernicterus are presented and evaluated. Cardiorespiratory stabilization, avoidance of displacing drugs, and preventive use of phototherapy appear to have decreased the incidence of low bilirubin kernicterus in high-risk newborns.