Bilirubin encephalopathy, usually occurs in newborns. A cranial magnetic resonance imaging (MRI) examination may show imaging abnormalities of the basal ganglia, thalamus and internal capsule. The main clinical signs are marked yellowing of the skin, mucous membranes and sclera throughout the body. Neonatal jaundice appears early and severe, with signs of hyporesponsiveness, lethargy, hypotonia, decreased activity and reduced attractiveness. Children with progressive disease may show signs of agitation, high-pitched crying, refusal of breast milk, apnea, dyspnea, and increased muscle tone. In severe cases, convulsions and corpus delicti may occur, and even coma and central respiratory failure. Chronic bilirubin encephalopathy can be characterized by markedly increased muscle tone and delayed mental and motor development.