Acute bilirubin encephalopathy (ABE) ABE is an acute state of elevated bilirubin in the central nervous system. Clinically, it encompasses a wide range of symptoms. These include lethargy, decreased feeding, hypotonia or hypertonia, a high-pitched cry, spasmodic torticollis, opisthotonus, setting sun sign, fever, seizures, and even death. If the bilirubin is not rapidly reduced, ABE quickly progresses to chronic bilirubin encephalopathy. Chronic bilirubin encephalopathy (CBE) CBE is a chronic state of severe bilirubin-induced neurological lesions. Reduction of bilirubin in this state will not reverse the sequelae. Clinically, manifestations of CBE include: # movement disorders – dyskinetic CP with often spasticity. 60% have severe motor disability (unable to walk). # auditory dysfunction – auditory neuropathy (ANSD) # visual/oculomotor impairments (nystagmus, strabismus, impaired upward or downward gaze, and/or cortical visual impairment). In rare cases, decreased visual acuity(blindness) can occur. # dental enamel hypoplasia/dysplasia of the deciduous teeth, # gastroesophageal reflux, # impaired digestive function. # slightly decreased intellectual function: Although most individuals (approximately 85%) with<unk>  fall in normal or dull-normal range. # epilepsy is uncommon. These impairments are associated with lesions in the basal ganglia, auditory nuclei of the brain stem, and oculomotor nuclei of the brain stem. Cortex and white matter are subtly involved. Cerebellum may be involved. Severe cortical involvement is uncommon. Subtle bilirubin encephalopathy (SBE) SBE is a chronic state of mild bilirubin-induced neurological dysfunction (BIND). Clinically, this may result in neurological, learning and movement disorders, isolated hearing loss and auditory dysfunction. * In the past it was thought that<unk>  (KI) often cause an intellectual disability. This was assumed due to difficulty with hearing, that is typically not detected in a normal audiogram accompanied by impairments of speech, with choreoathetosis. With advances in technology, this has proven to not be the case as those living with KI have repeatedly demonstrated their intelligence using Augmentative Communication devices . Although most individuals with kernicteric cerebral palsy have normal intelligence, some children with mild choreoathetosis develop dull normal intelligence or mild intellectual disability even without auditory dysfunction.
Kernicterus
Varices
Petechia
Rectal bleeding
Venospasm
Haemobilia
Vaginal bleeding
Hematochezia