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Neonatal auditory brainstem response cannot reliably diagnose brainstem death.

P R Dear, D J Godfrey

    Archives of Disease in Childhood
    |January 1, 1985
    PubMed
    Summary
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    Severe asphyxia in newborns can cause temporary auditory brainstem response loss. This temporary dysfunction in the auditory pathway does not necessarily indicate irreversible brain damage in infants.

    Area of Science:

    • Neuroscience
    • Pediatrics
    • Auditory Neuroscience

    Background:

    • Severe asphyxial insults in newborns can lead to significant neurological complications.
    • Brainstem dysfunction is a critical concern in neonates following hypoxic-ischemic events.
    • Auditory brainstem response (ABR) is a key diagnostic tool for assessing auditory pathway integrity.

    Observation:

    • Two newborn infants with severe asphyxia presented with clinical signs of brainstem dysfunction.
    • In these infants, auditory brainstem response testing revealed the absence of all ABR components except the eighth nerve potential.
    • This indicated a complete cessation of auditory signal conduction within the brainstem pathways.

    Findings:

    • Both infants survived the initial insult and showed a return of their brainstem responses.

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  • One infant was assessed at 18 months and found to be developmentally normal.
  • The recovery of ABR suggests the brainstem dysfunction was potentially reversible.

    • Implications:

    • Clinical signs of brainstem dysfunction and absent ABR components in newborns may not always signify irreversible brain damage.
    • These findings highlight the potential for recovery in the neonatal auditory pathway following severe asphyxia.
    • This underscores the importance of considering reversibility when interpreting ABR results in neonates with hypoxic-ischemic encephalopathy.