How to diagnose kernicterus

Kernicterus is actually also called neonatal bilirubin encephalopathy. It is mainly a type of brain damage caused by increased bilirubin in the child's body. If not treated in time, it may cause damage to the child's hearing, vision and other functions in severe cases. There is also a risk of cerebral palsy. Therefore, parents need to always pay attention to their children's health to prevent them from suffering from kernicterus. So how should kernicterus be diagnosed?

Bilirubin encephalopathy is caused by an increase in blood bilirubin, mainly unconjugated bilirubin, which enters the central nervous system and causes lesions in the basal ganglia, subthalamic nucleus, globus pallidus and other parts of the brain.

Pre-kernicterus:

Jaundice will gradually worsen, the reaction will become worse, and the baby will be drowsy, unable to suck milk or refuse to drink milk. Unconjugated bilirubin will increase to more than 256.5umol/L (15mg/dl).

Kernicterus Stage 1 (Warning Stage):

Symptoms are the same as those of pre-kernicterus, but much more severe, with unconjugated bilirubin greater than 427.5umol/L (greater than 25mg/dl)

The main manifestations are symptoms of inhibition such as drowsiness, refusal to breastfeed, hypotonia, weakened or disappeared hug reflex, and also apnea and bradycardia. The baby will enter the spasm stage after about half a day to one day.

Kernicterus Stage 2 (Spasmodic Stage):

The main manifestations are convulsions, increased muscle tone, groaning, screaming, staring, nystagmus, opisthotonos, convulsions, fever, irregular breathing, double inspiration, sobbing-like breathing, and even DIC, convulsions or excitement symptoms such as opisthotonos. The convulsion symptoms of premature infants may not be obvious. After treatment, surviving infants will enter the recovery period after 1 to 2 days.

The main manifestations of the recovery period are gradual recovery of sucking and reaction, followed by improved breathing, relief of convulsions, and reduction and disappearance of spasms. This period will last about 2 weeks.

Sequelae period:

Most patients who are successfully rescued will have sequelae, which usually appear 2 to 6 months after birth and are manifested by involuntary movements of the limbs, twisting of the head and trunk, difficulty in turning the eye upward or strabismus, hearing impairment, incomplete development of tooth enamel, crying and restlessness, intellectual disability, and eventually develop into athetoid cerebral palsy.

Precautions

Breast milk jaundice may be accompanied by symptoms such as jaundice after breastfeeding, physiological jaundice, and pathological jaundice in newborns. The newborn should go to the pediatric or gastroenterology department for treatment.

Jaundice may be accompanied by symptoms such as light yellow or dark golden skin, pathological jaundice, and increased bilirubin. You should go to the liver disease or gastroenterology department for treatment.