INTRODUCTION: "Kernicterus" is a term currently used to describe bilirrubin 
induced brain injury in the neuro-pathological studies. This is a confusing term 
and nowadays we prefer bilirrubin encephalopathy or bilirrubin induced 
neurological dysfunction. The clinical signs vary and it is clearly decreasing 
in prevalence in developed countries.
MATERIAL AND METHODS: We review a series of 7 patients with bilirrubin 
encephalopathy and variable neurological manifestations, who were seen in the 
Neuropaediatric Department in the last 10 years. Only one patient died in the 
neonatal period with hyperbilirubinaemia, sepsis and multi-organ failure.
RESULTS: Diverse aetiological factors were related to hyperbilirubinaemia. All 
patients had clinical symptoms due to hyperbilirubinaemia. Neuroimaging during 
the neonatal period showed involvement of the nucleus pallidus, with 
hyperintensity in T1 in the brain MR scan as the most consistent finding. All 
the patients who survived developed neurological signs and we try to correlate 
them with biochemical, clinical, neuroimaging and neurophysiological parameters.
CONCLUSIONS: An increase in the number of patients with bilirrubin 
encephalopathy has been observed over the last few years, and we attempt to find 
out the causes. The increased survival of the low birth weight newborns, the 
increase in the immigration population and the use of diagnostic neuroimaging 
contribute to this increase. It is a great challenge for the neonatologist and 
for neuropaediatricians to prevent its occurrence and to minimise the effects of 
bilirrubin encephalopathy.