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Utility of brainstem auditory evoked potentials in children with spastic cerebral palsy
D I Zafeiriou1, A Andreou, K Karasavidou
1First Pediatric Clinic, Aristotle University of Thessaloniki, Greece. jeff@med.auth.gr
Insights
Abnormal brainstem auditory evoked potentials (BAEP) in children with spastic cerebral palsy (CP) indicate a poor prognosis. These findings are linked to a "multihandicap state" and suggest incorporating BAEP testing into diagnostic plans.
Area of Science:
- Neuroscience
- Pediatrics
- Developmental Neurology
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder.
- Brainstem auditory evoked potentials (BAEP) assess auditory pathway function.
- Identifying prognostic indicators in spastic CP is crucial for management.
Purpose of the Study:
- To investigate the correlation between abnormal BAEP recordings and various clinical and radiological factors in children with spastic CP.
- To determine the prognostic value of BAEP in this population.
Main Methods:
- Retrospective analysis of 75 children with spastic CP.
- Recording of brainstem auditory evoked potentials (BAEP).
- Correlation of BAEP results with birthweight, gestational age, etiology, CP type, neuroimaging, and associated impairments.
Main Results:
- 17 patients (22.7%) had abnormal BAEP.
- Abnormal BAEP strongly associated with full-term delivery, perinatal etiology, spastic tetraplegia, speech and visual impairments, epilepsy, mental retardation, inability to walk, and cortical atrophy (p < 0.001).
- All patients with abnormal BAEP exhibited speech impairment and mental retardation.
Conclusions:
- Abnormal BAEP in spastic CP signifies a poor prognosis and a
- multihandicap state.
- BAEP testing should be integrated into the diagnostic workup for children with spastic CP.
- Early identification of prognostic factors aids in tailored intervention strategies.
Abstract:
In a retrospective study of 75 children with spastic cerebral palsy (CP), brainstem auditory evoked potentials (BAEP) were recorded and subsequently correlated with birthweight, gestational age, aetiology and type of CP, neuroradiological findings, additional impairments and disabilities (including the inability to walk independently). Seventeen patients (22.7%) had abnormal BAEP recordings. Thirteen of these 17 patients (76.5%) had spastic tetraplegia, 16 patients (94.1%) were full-term infants, 12 patients (70.6%) had myoskeletal problems, 9 (52.9%) had epilepsy, 16 (94.1%) had visual impairment, 13 patients (76.5%) were unable to walk independently, while all 17 patients (100%) had speech impairment and mental retardation. The aetiology of CP was prenatal in 2 of these 17 patients (11.8%) and perinatal in 15 patients (88.2%). Thirteen patients (76.5%) had cortical atrophy determined by either computed tomography or magnetic resonance imaging, two patients (11.8%) had an infarct picture and two patients (11.8%) had maldevelopment of the central nervous system. There was a definite statistically significant association between abnormal BAEP recordings and full-term delivery, perinatal aetiology of CP, spastic tetraplegia, speech, visual and myoskeletal impairments, epilepsy, mental retardation, inability to walk independently and cortical atrophy on neuroimaging (p < 0.001). We conclude that abnormal BAEP recordings in children with spastic CP are indicative of poor prognosis and associated with a "multihandicap state". BAEP testing should be incorporated into the diagnostic plan of all children with spastic CP newly referred to neurodevelopmental centres.