The magnetic resonance images (MRI) of three children with athetotic cerebral palsy and severe neonatal jaundice were examined in the Department of Pediatric Neurology, Ohzora-no-iye Hospital and Seirei-Mikatahara General Hospital, Shizuoka, Japan. High intensity areas in the posteromedial border of the globus pallidus on T2-weighted images were found bilaterally in all 3 children. No abnormalities were demonstrated on T1-weighted imaging. [1]

COMMENT. Kernicteric encephalopathy is a rare neonatal disorder since the introduction of phototherapy. Autopsy findings have revealed bilirubin staining of the globus pallidus, subthalamic nucleus, hippocampus, and dentate and olivary nuclei. The posteromedial border of the globus pallidus is the most sensitive region to kernicterus in MR imaging. Perinatal hypoxic-ischemic encephalopathy is distinguished by involvement of the putamen and thalamus on pathological and MR studies. The author lists other diseases with MR lesions in the globus pallidus including Leigh syndrome, Hallervorden-Spatz disease, hemolytic uremic syndrome (associated with E coli 0157:H7 and Shigella dysenteriae food poisoning), carbon monoxide intoxication, hepatic encephalopathy, and neurofibromatosis. See Progress in Pediatric Neurology II (PNB Publishers, 1994, pp242-3) for a previous article by the same author and commentary on MRI in 22 athetotic cerebral palsied children. The value of the MRI in the timing of basal ganglia pathology has been alluded to in other reports of dyskinetic and dystonic cerebral palsy (ibidem. pp243-4). Of 219 dyskinetic CP cases seen between 1955 and 1986 in the Cheyne CP Centre, Chelsea, London, 25% had been diagnosed with kernicterus.