Zeitschrift für Kinderheilkunde

, Volume 104, Issue 3, pp 168–178 | Cite as

Beitrag zur Symptomatologie der zentralnervösen Residualschäden durch Icterus gravis neonatorum

  • H. R. Hirt
Article
  • 13 Downloads

Schlüsselwörter

Icterus gravis neonatorum Radiculopathie Ataxie Bilirubinencephalopathie 

Contribution to the symptomatology of residual damage of the nervous system following severe neonatal jaundice

Summary

Damage to the central nervous system caused by hyperbilirubinaemia in the newborn is not rare even today.

A child is reported that developed a severe jaundice and was brought to the hospital on his third day of life with a serum bilirubin level of 57 mg%. Three exchange transfusions were carried out leading to a normal bilirubin level after 4 weeks. Subsequently the psychomotoric development of the child was retarded. The neurological examination at three years revealed a general muscular hypotonia, weak and inconstantly elicitable tendon reflexes, and a severe ataxia of the spinal type. In the electrophysiological examination of the peripheral nerves the H-reflex of the gastrocnemius muscle was absent but the F-reflex was regularly elicitable. The conduction velocity was normal. Thus the afferent branch of the reflex are was damaged and the efferent branch intact. Therefore a lesion of the posterior roots, especially of the proprioceptive fibres (or of the spinal ganglion) must be assumed.

The pathogenesis of the above case is discussed with reference to the literature on kernicterus and bilirubin encephalopathy of the newborn. According to clinical and experimental data a predilective toxic effect of bilirubin on the spinal ganglion and the posterior roots can be postulated. Thus it seems that lesions of the nerve roots after severe neonatal jaundice, if investigated, may not be so rare.

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Copyright information

© Springer-Verlag 1968

Authors and Affiliations

  • H. R. Hirt
    • 1
  1. 1.Universitäts-Kinderklinik BaselBaselSchweiz

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