Visuocortical bilirubin-induced neurological dysfunction

SummaryThis review addresses the question whether elevated levels of total serum/plasma bilirubin (TB) cause measurable neurological effects, specifically to visuocortical functioning. Past research in the area of vision and its relation to jaundice has taken advantage of flash visual-evoked potentials (VEPs). Using a steady state VEP, we developed preliminary data suggesting that children who had jaundice with TB levels between 10 and 25 mg/dL, but who did not have kernicterus, have measurable changes in visual function, when compared to control infants who did not have jaundice. This non-invasive test offers information about vision thresholds, signal amplitudes, and suprathreshold changes after brain exposure to bilirubin. Here, we review this novel tool, the steady state VEP, and data suggesting that neurological changes occur in infants with moderately elevated TB levels.