Multimodality electroneurophysiological findings in intra-axial and extra-axial lesions of the brain stem

In 330 patients with a space occupying lesion of the posterior cranial fossa, the blink (BR) and masseter (MR) reflexes and brain stem auditory (BAEP) and somatosensory evoked potentials (SEP) were registered. The aim of our study was to look for electrophysiological criteria of differentiating between lesions within or outside the brain stem. The ipsilateral loss of BAEP in cerebellopontine angle tumours and the altered SEP in tumours within the brain stem turned out as frequent, almost specific findings. Prolonged ipsi-and contralateral late BR responses and prolonged MR responses, a long somatosensory central conduction time of the SEP and a prolonged wave III latency as well as a prolonged interpeak latency of the BAEP are not indicative but highly suspicious for a lesion within the brain stem. Prolonged early responses of the BR together with prolonged interpeak latencies of the BAEP are characteristic findings in cerebello-pontine angle tumours.