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Movement disorders due to bilirubin toxicity.
Semin Fetal Neonatal Med. 2015 Feb; 20(1):20-25.SF

Abstract

Advances in the care of neonatal hyperbilirubinemia have led to a decreased incidence of kernicterus. However, neonatal exposure to high levels of bilirubin continues to cause severe motor symptoms and cerebral palsy (CP). Exposure to moderate levels of unconjugated bilirubin may also cause damage to the developing central nervous system, specifically the basal ganglia and cerebellum. Brain lesions identified using magnetic resonance imaging following extreme hyperbilirubinemia have been linked to dyskinetic CP. Newer imaging techniques, such as diffusion tensor imaging or single-photon emission computed tomography, allow quantification of more subtle white matter injury following presumed exposure to unbound bilirubin, and may explain more subtle movement disorders. New categories of bilirubin-induced neurologic dysfunction, characterized by subtle bilirubin encephalopathy following moderate hyperbilirubinemia, have been implicated in long-term motor function. Further research is needed to identify subtle impairments resulting from moderate-severe neonatal hyperbilirubinemia, to understand the influence of perinatal risk factors on bilirubin toxicity, and to develop neuroprotective treatment strategies to prevent movement disorders due to bilirubin toxicity.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA; Motion Analysis Laboratory, Lucile Packard Children's Hospital, Stanford, CA, USA; Neonatal Neuroimaging Laboratory, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: jessica.rose@stanford.edu.Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA; Neonatal Neuroimaging Laboratory, Stanford University School of Medicine, Stanford, CA, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

25524299

Citation

Rose, Jessica, and Rachel Vassar. "Movement Disorders Due to Bilirubin Toxicity." Seminars in Fetal & Neonatal Medicine, vol. 20, no. 1, 2015, pp. 20-25.
Rose J, Vassar R. Movement disorders due to bilirubin toxicity. Semin Fetal Neonatal Med. 2015;20(1):20-25.
Rose, J., & Vassar, R. (2015). Movement disorders due to bilirubin toxicity. Seminars in Fetal & Neonatal Medicine, 20(1), 20-25. https://doi.org/10.1016/j.siny.2014.11.002
Rose J, Vassar R. Movement Disorders Due to Bilirubin Toxicity. Semin Fetal Neonatal Med. 2015;20(1):20-25. PubMed PMID: 25524299.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Movement disorders due to bilirubin toxicity. AU - Rose,Jessica, AU - Vassar,Rachel, Y1 - 2014/12/16/ PY - 2014/12/20/entrez PY - 2014/12/20/pubmed PY - 2016/1/1/medline KW - Cerebral palsy KW - Gait KW - Kernicterus KW - Neonatology KW - Neurodevelopment KW - Preterm infants SP - 20 EP - 25 JF - Seminars in fetal & neonatal medicine JO - Semin Fetal Neonatal Med VL - 20 IS - 1 N2 - Advances in the care of neonatal hyperbilirubinemia have led to a decreased incidence of kernicterus. However, neonatal exposure to high levels of bilirubin continues to cause severe motor symptoms and cerebral palsy (CP). Exposure to moderate levels of unconjugated bilirubin may also cause damage to the developing central nervous system, specifically the basal ganglia and cerebellum. Brain lesions identified using magnetic resonance imaging following extreme hyperbilirubinemia have been linked to dyskinetic CP. Newer imaging techniques, such as diffusion tensor imaging or single-photon emission computed tomography, allow quantification of more subtle white matter injury following presumed exposure to unbound bilirubin, and may explain more subtle movement disorders. New categories of bilirubin-induced neurologic dysfunction, characterized by subtle bilirubin encephalopathy following moderate hyperbilirubinemia, have been implicated in long-term motor function. Further research is needed to identify subtle impairments resulting from moderate-severe neonatal hyperbilirubinemia, to understand the influence of perinatal risk factors on bilirubin toxicity, and to develop neuroprotective treatment strategies to prevent movement disorders due to bilirubin toxicity. SN - 1878-0946 UR - https://wwww.unboundmedicine.com/medline/citation/25524299/Movement_disorders_due_to_bilirubin_toxicity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1744-165X(14)00087-0 DB - PRIME DP - Unbound Medicine ER -