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Brainstem auditory evoked potentials following meningitis in children
1Hospices Civils de Lyon, Service d'Exploration Neurosensorielle, France.
Insights
Brainstem auditory evoked potentials (BAEPs) effectively screen for hearing loss in children post-bacterial meningitis. Abnormal BAEPs indicate transmission, endocochlear, or retrocochlear impairments, guiding treatment for hearing deficits.
Area of Science:
- Pediatric Neurology
- Audiology
- Infectious Diseases
Background:
- Bacterial meningitis is a significant cause of childhood morbidity.
- Neurological complications are common sequelae of bacterial meningitis.
- Hearing impairment is a potential complication of bacterial meningitis.
Purpose of the Study:
- To evaluate the utility of brainstem auditory evoked potentials (BAEPs) in assessing hearing function in children after bacterial meningitis.
- To characterize the types and prevalence of auditory pathway impairments detected by BAEPs.
- To correlate BAEP findings with specific bacterial agents and neurological complications.
Main Methods:
- BAEPs were recorded in 116 children aged 0-7 years with a history of bacterial meningitis.
- Clinical ear examinations were performed concurrently.
- Bacterial meningitis etiology and neurological complications were documented.
Main Results:
- 29% of children exhibited abnormal BAEPs, indicating auditory pathway dysfunction.
- Transmission impairment was most common in younger children (<2 years) and associated with meningococcal meningitis.
- Retrocochlear impairment correlated with neurological complications, while endocochlear impairment (including cophosis) occurred independently of neurological issues.
- Hemophilus influenzae was the most frequent bacterial cause overall, while Streptococcus pneumoniae was associated with cophosis.
Conclusions:
- BAEP testing, combined with clinical ear examination, is valuable for detecting and characterizing hearing loss in children post-bacterial meningitis.
- BAEPs aid in differentiating between partial and total hearing loss (cophosis) and inform treatment strategies.
- Early identification of auditory impairments can lead to timely intervention and improved outcomes.
Abstract:
The report concerns findings for brainstem auditory evoked potentials (BAEPs) recorded in 116 children, aged between a few days and 7 years, having suffered from bacterial meningitis. 26% of cases occurred between birth and 6 months, 55% between 6 months and 2 years, and 19% after 2 years of age. Hemophilus was the most common bacteria (49%), followed by Pneumococcus (22%) and Meningococcus (15%). Neurological complications were found in 30% of the meningitis cases and accounted for 85% of all complications found. 29% of BAEPs were abnormal, of which 47% revealed transmission, 32% endocochlear and 21% retrocochlear impairment. Transmission impairment mainly occurred before the age of 2 years (88%), most frequently in meningococcus meningitis cases (44%), and independently of neurological complications. Retrocochlear impairment was found in association with neurological complications in 71% of cases. Endocochlear BAEP damage was found in 9.5% of cases, half of which were bilateral and total, representing cophosis: it was found at all ages, and without any particular associated neurological complication. Hemophilus was the commonest bacterial agent in endocochlear cases overall, with Pneumococcus underlying 50% of cophosis cases. The study shows BAEP recording in association with a clinical ear examination is useful following childhood bacterial meningitis, screening for definitive endocochlear and deafness, distinguishing total from partial hearing-loss and indicating suitable treatment.