Abstract

Background: Early during life, excessive hyperbilirubinemia results in accumulation of bilirubin in the grey matter of the brain causing neurotoxicity with damage of neurons by apoptosis and necrosis leading to irreversible brain damage called kernicterus and bilirubin encephalopathy. Clinical manifestations of kernicterus include ataxic form of cerebral palsy. We have previously reported the novel use of cerebrolysin and citicoline in the treatment of a girl with kernicterus who experience improvement without the occurrence of side effects. The aim of this paper is to describe the beneficial use of cerebrolysin and citicoline a boy with ataxic form of cerebral palsy caused by kernicterus.

Patients and Methods: The treatment of a two-year old boy with ataxic cerebral palsy caused by kernicterus associated with delayed speech is described. Before treatment, the boy had difficulty in sitting without support for more than few seconds and was holding the chair to keep his position. He could stand holding furniture and could stand alone for seconds but was unable to take any further step without support. The boy was treated with intramuscular cerebrolysin 3 ml every other day (15 doses), and intramuscular citicoline 3 ml (375 mg) every other day. 

Results: After treatment, the boy was able to sit without support for long time and could stand without holding anything for long time.

Conclusion: The use of intramuscular cerebrolysin and citicoline was associated with some improvement and was found to be beneficial without the occurrence of any side effects. 

Keywords: Ataxic Cerebral Palsy; Kernicterus; Treatment; Cerebrolysin; Citicoline

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