Clinical manifestations of acute bilirubin encephalopathy and kernicterus * Condition Phase Clinical manifestations Acute bilirubin Early Lethargy encephalopathy Hypotonia Poor suck Intermediate Moderate stupor Irritability Hypertonia manifested by backward arching of the neck (retrocollis) and trunk (opisthotonos
) Fever and high-pitched cry, which may alternate with drowsiness and hypotonia Advanced Pronounced retrocollis and opisthotonos
Shrill cry No feeding Apnea Fever Deep stupor to coma Sometimes seizures and death Kernicterus NA Athetoid cerebral palsy Auditory dysfunction Dental-enamel dysplasia Paralysis of upward gaze Some or all of the signs listed in the advanced phase of bilirubin encephalopathy * From 2004 clinical guidelines (reference 4).
It was decided to have palliative chemotherapy and radiation therapy especially to improve his neck extension, opisthotonos
and to make him more comfortable.
On March 30, Cal began exhibiting movements described as opisthotonos
, arching, or hyperextension of the neck.
This kind of behavior, some of which resembled la grande hysterie of Charcot (even including opisthotonos
, a characteristic distortion of bodily posture), continued until Robbie recovered, in the middle of April 1949.
Clinical signs consisted of vulvar hemorrhage in the does, epistaxis, ataxia, opisthotonos
, diarrhea, ocular discharge, vocalization, and death.