Assessment of brainstem function in Chiari II malformation utilizing brainstem auditory evoked potentials (BAEP), blink reflex and masseter reflex

Koehler, Jana; Schwarz, Manfred; Boor, Rainer; Hölker, Cordula; Hopf, Hanns Christian; Voth, D.; Ermert, August

doi:10.1016/s0387-7604(00)00162-5

Cited by 13 publications

(3 citation statements)

References 20 publications

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“…Many studies have investigated ABR testing for early detection of brainstem dysfunction in patients with MMC. 1,5,6,12,14,18,19,21,33 Waves I, III, and V of the ABR are believed to originate from the distal auditory nerve, cochlear nucleus, and lateral lemniscus, respectively. 17 The IPL between Waves I and V (I-V IPL), which reflects conduction time from inner ear to midbrain, is prolonged in most patients with MMC.…”

Section: Diagnostic Abr Testing In Patients With MMCmentioning

confidence: 99%

“…17 The IPL between Waves I and V (I-V IPL), which reflects conduction time from inner ear to midbrain, is prolonged in most patients with MMC. 1,5,6,12,14,33 The III-V IPL is initially prolonged 5,19 but normalizes with age, 6,18,21 suggesting delayed brainstem maturation in MMC. In contrast, the I-III IPL increases with age, consistent with growing tension on the auditory nerve.…”

Section: Diagnostic Abr Testing In Patients With MMCmentioning

confidence: 99%

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Prognostic value of newborn hearing screening in patients with myelomeningocele

Satzer¹,

Guillaume²

2014

PED

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Object Brainstem dysfunction occurs in a minority of patients with myelomeningocele (MMC), most of whom have Chiari Type II malformation. Some surgeons advocate early identification of these patients for craniocervical decompression to avoid significant mortality. The auditory brainstem response has been found to be abnormal in most children with MMC. The present study examines whether failure of routine newborn hearing screening (NHS) predicts brainstem dysfunction in MMC patients. Methods The charts of 40 newborns with MMC and 50 newborns without MMC who stayed in the neonatal intensive care unit were reviewed. Results of NHS, brainstem symptoms, birth demographics, and surgical history were retrospectively examined. Differences in the presence and onset of brainstem symptoms by NHS result were assessed. Results Failure of NHS was more common among newborns with MMC who developed brainstem symptoms (31%, 4 of 13 patients) than among newborns without MMC (0%, 0 of 50 patients; p = 0.001). Among the 40 newborns with MMC, brainstem symptoms were more common in those who failed NHS (80%, 4 of 5 patients) than in those who passed (26%, 9 of 35 patients; p = 0.031). Respiratory symptom onset occurred later in patients who failed NHS (median 16 months) than among those who passed (median 0 months; p = 0.022). The positive and negative predictive values of NHS for brainstem dysfunction in MMC were 0.80 and 0.74, respectively. Conclusions Results of NHS may help predict future brainstem dysfunction in patients with MMC and may be useful to incorporate into prognostic assessment and surgical decision making.

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Section: Diagnostic Abr Testing In Patients With MMCmentioning

confidence: 99%

Section: Diagnostic Abr Testing In Patients With MMCmentioning

confidence: 99%

Prognostic value of newborn hearing screening in patients with myelomeningocele

Satzer¹,

Guillaume²

2014

PED

View full text Add to dashboard Cite

show abstract

“…In Chiari II malformation, however, imaging is not equally valid and additional data are required for the decision of surgical intervention. MassR testing showed low rates of abnormal findings (20%) in asymptomatic patients and high rates (67%, odds ratio 15.5) in symptomatic patients 15, 16. The MassR was less sensitive but more specific (0.79) compared with the general BlinkR data.…”

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confidence: 84%