Document Detail

Auditory Brainstem Response audiometry. Applications in central disorders.
MedLine Citation:
PMID:  4011254     Owner:  NLM     Status:  MEDLINE    
ABR is the most sensitive and specific test in the audiology battery for detecting disorders that affect the brainstem. When combined with central speech audiometry, ABR can detect most intra- and extra-axial tumors, demyelinating lesions, and polyneuropathies that affect brainstem auditory structures. Alone, it is a promising tool for monitoring neural maturation, tumor growth, coma, and neurologic or vascular therapies. The test can be severely compromised by peripheral hearing loss and knowledge of the audiogram is a prerequisite for any central testing application of ABR. Six cases of intra- or extra-axial brainstem pathology are described here. ABR results were abnormal in all but one case, based on response latency measurements. In two cases, ABR was the only audiologic test that detected the abnormality. In general, ABR was sensitive to and conventional tests were insensitive to central lesions involving the eighth nerve. ABR abnormalities were not in themselves sufficient to define the precise site of the lesion, nor could they determine the kind of lesion present. However, they were indicative of the level and extent of direct involvement by the disease process or of the pressure and distortion effects of the lesion on the brainstem. In one case where ABR failed to detect the lesion, central speech testing was abnormal. The potential usefulness of ABR to monitor brainstem status is emphasized. A case is described where ABR provided valuable information on the effects of an experimental embolic therapy for AVM. Special precautions are described for monitoring ABR in neonates. ABR is an important screening test for the detection of brainstem disorders, especially those that cannot be detected radiographically. Its greatest use, however, may prove to be as inexpensive and noninvasive monitor of brainstem status in patients with confirmed or suspected brainstem disorders.
H Hosford-Dunn
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Otolaryngologic clinics of North America     Volume:  18     ISSN:  0030-6665     ISO Abbreviation:  Otolaryngol. Clin. North Am.     Publication Date:  1985 May 
Date Detail:
Created Date:  1985-08-20     Completed Date:  1985-08-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0144042     Medline TA:  Otolaryngol Clin North Am     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  257-84     Citation Subset:  IM    
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MeSH Terms
Audiometry, Evoked Response*
Auditory Threshold / physiology
Brain Neoplasms / diagnosis
Brain Stem / physiopathology
Cerebellar Neoplasms / diagnosis
Cerebrovascular Disorders / diagnosis
Diagnosis, Differential
Hearing Loss, Central / diagnosis*,  physiopathology
Hearing Loss, Sensorineural / diagnosis*
Hearing Tests
Medulloblastoma / diagnosis
Meningeal Neoplasms / diagnosis
Meningioma / diagnosis
Middle Aged
Multiple Sclerosis / diagnosis
Neuroma, Acoustic / diagnosis
Reaction Time / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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