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Assessment of brainstem function in Chiari II malformation utilizing brainstem auditory evoked potentials (BAEP),
1Department of Neurology, University hospital Mainz, Johannes-Gutenberg University, 55101, Mainz, Germany. koehler@neurologie.klinik.uni-mainz.de
Brain & Development
|December 5, 2000
Summary
Brainstem auditory evoked potentials (BAEP) and blink reflex (BR) are sensitive for detecting brainstem dysfunction in myelomeningocele patients. Masseter reflex (MR) and BR accurately identify Chiari II malformation symptoms, aiding treatment decisions.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Clinical Neurophysiology
Background:
- Myelomeningocele is a complex congenital condition often associated with Chiari II malformation.
- Brainstem dysfunction can manifest in patients with myelomeningocele and Chiari II malformation, impacting neurological function.
- Objective assessment of brainstem involvement is crucial for guiding clinical management.
Purpose of the Study:
- To evaluate brainstem dysfunction in patients with myelomeningocele and Chiari II malformation.
- To compare the diagnostic utility of brainstem auditory evoked potentials (BAEP), blink reflex (BR), and masseter reflex (MR).
- To determine the accuracy of these neurophysiological tests in identifying brainstem signs related to Chiari II malformation.
Main Methods:
- Sixty-seven patients with myelomeningocele were assessed using BAEP, BR, and MR.
- Clinical signs and symptoms related to Chiari II malformation were documented.
- Sensitivity and accuracy of each reflex test were calculated for detecting brainstem involvement and Chiari II-related symptoms.
Main Results:
- Brainstem auditory evoked potentials (BAEP) demonstrated the highest sensitivity (1.0) for brainstem involvement, followed by blink reflex (BR) (0.83).
- Masseter reflex (MR) (0.72) and BR (0.52) showed higher accuracy than BAEP (0.39) in differentiating patients with Chiari II-related symptoms.
- Eighteen patients exhibited signs/symptoms of Chiari II malformation, while 49 had normal brainstem findings.
Conclusions:
- Brainstem reflexes, particularly BR and MR, are valuable tools for assessing brainstem function in myelomeningocele patients.
- The higher accuracy of BR and MR may stem from the specific neuroanatomical pathways they engage.
- These neurophysiological findings can assist clinicians in making informed decisions regarding further treatment for patients with myelomeningocele and Chiari II malformation.
