Kernicterus has been referred to a disease of the past. However, we report two cases of kernicterus presenting with a dyskinetic movement disorder. Both cases had neonatal jaundice and were well until the age of 3 years with normal intellect. On examination dystonia, dyskinesia and chorea were seen. Further examination revealed an upgaze palsy and auditory neuropathy.
Kernicterus describes a neurological syndrome resulting from deposition of unconjuated bilirubin in basal ganglia & brainstem nuclei.
With the recent NICE guidance for jaundice therapy these cases highlight the importance of rigorous treatment of hyperbilirubinaemia. They also remind us to consider kernicterus as a diagnosis in a child presenting with a movement disorder and normal intellect.