• Unconjugated bilirubin crossing the blood-brain barrier → neuronal toxicity →n excitotoxicity, mitochondrial dysfunction, and apoptosis.

Clinical manifestations of kernicterus (Irreversible brain damage) include:

• CP - Cerebral Palsy : Abnormal, involuntary movements and muscle tone abnormalities.
• SNHL : Often presenting as auditory neuropathy or auditory dys-synchrony.
• Vertical Gaze Palsy: Particularly impairment of upward gaze
• NDD/IDD : Ranging from mild to severe cognitive impairment.