Related Experiment Videos
Brainstem auditory evoked potential abnormalities in myelomeningocoele in the older child
T B Docherty1, A G Herbaut, E M Sedgwick
1Wessex Neurological Centre, Southampton, UK.
Insights
Brainstem auditory evoked potentials (BAEPs) were abnormal in most children with myelomeningocele, suggesting brainstem dysgenesis. BAEPs may not reliably predict Arnold-Chiari malformation in these patients.
Area of Science:
- Pediatric Neurology
- Neurophysiology
- Developmental Neuroscience
Background:
- Myelomeningocele is a complex congenital condition often associated with neurological deficits.
- Hydrocephalus is a common complication requiring management, typically with shunting.
- Arnold-Chiari malformation is frequently observed in myelomeningocele patients.
Purpose of the Study:
- To investigate brainstem auditory evoked potentials (BAEPs) in children with myelomeningocele.
- To correlate BAEP findings with clinical status and hydrocephalus management.
- To assess the utility of BAEPs in evaluating brainstem integrity and associated malformations.
Main Methods:
- BAEPs were recorded in 18 children (age > 5 years) with surgically treated myelomeningocele.
- Participants included those with hydrocephalus managed by shunting.
- Comparisons were made with normal controls and patients with hydrocephalus only.
Main Results:
- Over 94% of myelomeningocele patients exhibited abnormal BAEPs.
- 72% demonstrated significant delays in interpeak latencies (II-V and I-V).
- Abnormalities suggest underlying brainstem dysgenesis, potentially linked to Arnold-Chiari malformation.
Conclusions:
- BAEP abnormalities are common in children with myelomeningocele, likely reflecting brainstem dysgenesis.
- The clinical significance of these BAEP findings for predicting symptomatic Arnold-Chiari malformation is uncertain.
- Further research is needed to clarify the role of BAEPs in monitoring myelomeningocele-related neurological complications.
Abstract:
Brainstem auditory evoked potentials and clinical findings were examined in 18 children over the age of 5 years who were born with myelomeningocoele which was closed at birth, and whose hydrocephalus was managed by long term shunting in most of them. The potentials were compared with age and sex matched normal subjects and with four patients with hydrocephalus only. All but one had an abnormal brainstem auditory evoked potential with 72% showing a delay in the II-V and I-V interpeak latencies of more than three standard deviations. It is proposed that the abnormalities are a reflection of brainstem dysgenesis which is part of an associated Arnold-Chiari malformation, though the malformation was clinically asymptomatic in all. The usefulness of the brainstem auditory evoked potential for assessing the course of hydrocephalus and for predicting symptomatic Arnold-Chiari malformation is questioned.