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Auditory system dysfunction due to infantile thiamine deficiency: long-term auditory sequelae
J Attias1, E Raveh, A Aizer-Dannon
1Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel. attiasj@netvision.net.il
Insights
Thiamine deficiency in infants can cause auditory neuropathy spectrum disorder (ANSD) and hearing loss. Supplementation can resolve ANSD, but long-term developmental delays may persist.
Area of Science:
- Pediatrics
- Neuroscience
- Otolaryngology
Background:
- Thiamine (Vitamin B1) is essential for neural development and function.
- Infant nutrition plays a critical role in auditory system development.
- Auditory neuropathy spectrum disorder (ANSD) presents diagnostic challenges in infants.
Purpose of the Study:
- To evaluate immediate and long-term auditory abnormalities in infants with thiamine deficiency.
- To investigate the impact of thiamine supplementation on auditory outcomes.
- To establish thiamine deficiency as a potential acquired metabolic cause of ANSD.
Main Methods:
- Retrospective evaluation of eleven infants fed a thiamine-deficient formula.
- Auditory assessments including audiograms and brainstem auditory evoked potentials.
- Long-term follow-up (6-8 years) assessing auditory and language development.
Main Results:
- Eight of eleven infants presented with auditory neuropathy spectrum disorder (ANSD).
- Five infants with ANSD showed resolution with thiamine supplementation; two had permanent hearing loss.
- Survivors experienced language delays and impaired speech intelligibility, particularly with background noise.
Conclusions:
- Thiamine deficiency is a significant acquired metabolic cause of ANSD in infants.
- Early thiamine supplementation can reverse ANSD in some cases.
- Long-term auditory and speech deficits necessitate ongoing developmental monitoring.
Abstract:
Eleven infants who were fed a thiamine-deficient formula for a mean of 3 months were evaluated for immediate and long-term auditory abnormalities. At presentation, 8 infants had auditory neuropathy spectrum disorder (ANSD), which resolved with supplementary thiamine in 5 children, was permanent in 2 children, and deteriorated in 1 patient who died at the age of 7 years. An additional patient had an auditory pattern corresponding to that of auditory neuropathy of brain stem origin. The 2 remaining patients had unilateral cochlear hearing loss. Six to 8 years later, all patients with transient ANSD had normal audiograms, 2 patients had unilateral cochlear hearing loss, and the rest had neural hearing loss. All survivors had a language developmental delay and impaired speech intelligibility of varying degrees, especially in the presence of background noise. Thiamine is crucial for normal auditory development and function, and its deficiency may be considered an acquired metabolic cause of ANSD in infants.
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