KERNICTERUS & MEDICAL NEGLIGENCE CLAIMS

Kernicterus is a type of brain damage in babies caused by jaundice. Jaundice is a condition that turns the skin and eyes yellow due to high levels of bilirubin. It is common for babies to be jaundiced; however, deeply jaundiced babies have very high amounts of bilirubin that move out of the bloodstream and into the brain’s tissue. When this happens, they become very lethargic and can begin to develop brain damage. This is noted by excessive sleepiness, they are difficult to wake up from sleep, they are unable to awaken fully and they cannot stay awake. These babies often have a high pitched cry and decreased muscle tone issues, such as being very floppy or hypotonic. They may also develop increased muscle tone, which is evidenced by backward arching of the head and back. As the brain damage progresses, the baby may develop a fever and hold his or her head in a very contorted position called “retrocollis” or “opisthotonus”.

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Meaning of Kernicterus

The name kernicterus is derived from the Greek “kern” (meaning kernel) and “icterus” (meaning yellow). The term refers to the deep nuclei (the kernel) of the brain, more specifically the basal ganglia, becoming stained yellow. Kernicterus affects the globus pallidus, a very distinct part of the basal ganglia. It can also include brainstem nuclei lesions that affect hearing, eye movement, coordination and balance. These damaged areas are viewable on MRI scans.

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Four Main Elements

Kernicterus typically involves four main elements: movement disorders; deafness or some level of hearing loss; an upward gaze or other impairment of eye movement; and, the abnormal staining of teeth enamel. Kernicterus falls into the dystonic or athetoid categories of cerebral palsy. Athetoid cerebral palsy is classified by slow, involuntary movements. Dystonia refers to abnormal muscle tone and can occur without athetoid symptoms. Some individuals affected with kernicterus are completely deaf, while others have no hearing issues. Some may have problems with auditory processing, known as auditory “dys-synchrony” or “auditory neuropathy”.

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A Rare Condition

It is important to note occurrences of kernicterus cases are quite rare. That said, acute kernicterus is a very serious issue that needs to be addressed quickly. When signs of this condition are present, brain damage is occurring. Treatment must be administered immediately to stop the damage, prevent further damage and, perhaps, reverse some of the damage already done.

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Treatment

Babies diagnosed with high bilirubin levels can be effectively treated before brain damage occurs. Treatment with lights, known as “phototherapy”, is typically used and has been found to be very effective. This type of treatment makes use of the blue color in visible light, which alters the bilirubin to a non-toxic form that is water soluble and easily eliminated from the body. The treatment is carried out by placing phototherapy lights as close the baby as possible, while regularly monitoring bilirubin levels in the blood. Phototherapy is safe and should be commenced if kernicterus is suspected, without awaiting results from the first lab tests. The baby should be hydrated with plenty of fluids and fed formula through a tube. At this time, the baby should also be blood typed in case an exchange transfusion is required.

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Blood Transfusion

If bilirubin has reached excessively high, dangerous levels or in situations where bilirubin is predicted to rise quickly, an exchange transfusion, which is a more drastic treatment, will most likely be necessary. This procedure promptly removes toxic bilirubin from the blood and may be necessary when Rh or other hemolytic diseases are present in newborns.

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Specialist Solicitors

If you would like free legal advice on personal injury compensation claims just use the helpline, complete the contact form or email our offices and a specialist medical negligence solicitor will telephone you with no further obligation. Following a review of the circumstances of the injury and of the medical records you will be advised whether your child has a reasonable claim and if so, what steps you should take to protect your legal right to receive compensation. All of our lawyers use no win no fee arrangements to represent their clients which means that if your solicitor doesn't achieve settlement then he doesn't get paid his professional costs and the client does not receive a bill for legal costs.