Brainstem auditory and visual evoked potentials in infants with myelomeningocele
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Updated: Nov 1, 2026
Infant Auditory Processing and Event-related Brain Oscillations
Published on: July 1, 2015
M J Taylor1, R Boor, N K Keenan
1Division of Neurology, Hospital for Sick Children, Toronto, Ont., Canada.
Insights
Brainstem auditory evoked potentials (BAEPs) show promise for predicting neurological outcomes in infants with myelomeningocele, especially those with symptomatic Arnold-Chiari malformation. Visual evoked potentials (VEPs) were less effective prognostically.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Clinical Electrophysiology
Background:
- Myelomeningocele is a complex congenital condition affecting neurological development.
- Early assessment of neurological status and prognosis is crucial for infants with myelomeningocele.
- Evoked potentials, including BAEPs and VEPs, are non-invasive tools to evaluate neural pathway function.
Purpose of the Study:
- To evaluate the early neurological status and prognostic value of Brainstem Auditory Evoked Potentials (BAEPs) and Visual Evoked Potentials (VEPs) in infants with myelomeningocele.
- To determine if BAEPs and VEPs can predict long-term neurological outcomes.
- To assess the correlation between evoked potentials and the presence of symptomatic Arnold-Chiari malformation.
Main Methods:
- Recording of BAEPs and VEPs in 47 infants with myelomeningocele within 3 months of age.
- Clinical assessment of neurological outcome at a mean follow-up of 2 years.
- Analysis of evoked potential results in relation to symptomatic Arnold-Chiari malformation and neurological sequelae.
Main Results:
- Normal BAEPs were observed in 41% and normal VEPs in 62% of infants.
- BAEPs were abnormal in all 9 infants with symptomatic Arnold-Chiari malformation.
- Abnormal BAEPs predicted central neurological abnormalities with 88% positive predictive value and 84% accuracy.
- VEPs showed lower sensitivity and predictive value compared to BAEPs for neurological outcomes.
Conclusions:
- BAEPs are valuable for early prediction of neurological sequelae in infants with myelomeningocele, particularly in cases of symptomatic Arnold-Chiari malformation.
- VEPs are not sufficiently sensitive for prognostic use in this population.
- Early electrophysiological assessment using BAEPs can aid in managing and understanding the neurological trajectory of infants with myelomeningocele.
Abstract:
Brainstem auditory evoked potentials (BAEPs) and visual evoked potentials (VEPs) were recorded in 47 infants with myelomeningocele to determine if the evoked potentials reflected the early neurological status, and if they had prognostic value as to the children's neurological outcome. The infants were tested between 1 day and 3 months of age (mean 24 days), while still in hospital after the myelomeningocele repair. Outcome was assessed at a mean of 2 years of age. Normal BAEPs were found in 41% and normal VEPs in 62% of the patients. BAEPs were abnormal in all infants studied who had symptomatic Arnold-Chiari (AC) malformation (n = 9); VEPs were abnormal in only 55% of symptomatic infants. Of the infants who did not have symptomatic AC malformation, 53% had normal BAEPs, 69% had normal VEPs. Of the patients with normal BAEPs, 81% had normal cerebral function on follow-up. Of the patients with abnormal BAEPs, 87% had central neurological abnormalities on follow-up. Of the patients with normal VEPs, 63% were normal on follow-up; of the patients with abnormal VEPs, 71% were abnormal on follow-up. Thus, the VEPs studied early in the neonatal course do not appear to be sufficiently sensitive to be valuable prognostically in these infants. However, the BAEPs were consistently abnormal in symptomatic AC malformation and showed a positive predictive value of 88% and an accuracy in predicting central neurological sequelae of 84%.
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