We believe that the syndrome of
bilirubin-induced
neurologic dysfunction [BIND] represents a spectrum of
neurologic manifestations among vulnerable infants who have experienced an exposure to
bilirubin of lesser degree than generally described in previous publications. Clinical neuro-motor manifestations extend to a range of subtle processing disorders with objective disturbances of visual-motor, auditory, speech, cognition, and language among infants with a previous history of moderate-to-severe
hyperbilirubinemia of varied duration. Confounding effects include prematurity,
hemolysis, perinatal-neonatal complications, altered
bilirubin-
albumin binding, severity and duration of
bilirubin exposure, and the individual vulnerability of the infant related to genetic, family, social, and educational predilection, regardless of the cause of
neonatal jaundice. Tools to better assess BIND specific domains of multisensory processing disorders, identified by pyschometric, audiologic, speech, language and visual-motor, and neuromotor examination would allow for prospective surveillance of infants at risk for the syndrome.