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Brainstem auditory-evoked potential evaluation in children with meningitis
1Department of Paediatrics, The First Teaching Hospital, Beijing Medical University, PR China.
Insights
Meningitis can cause significant hearing loss in children, with over 27% showing impairment on brainstem auditory-evoked potential (BAEP) tests. Follow-up BAEP testing is crucial for monitoring hearing status, especially after bacterial or aseptic meningitis.
Area of Science:
- Neurology
- Pediatrics
- Audiology
Background:
- Meningitis is a serious infection that can lead to various complications in children.
- Hearing impairment is a known but often underdiagnosed sequela of meningitis.
Purpose of the Study:
- To determine the incidence of hearing impairment in children following meningitis using brainstem auditory-evoked potential (BAEP).
- To evaluate the utility of BAEP in screening and follow-up for hearing loss in pediatric meningitis patients.
Main Methods:
- Brainstem auditory-evoked potential (BAEP) was conducted on 101 children diagnosed with meningitis (bacterial, viral, or aseptic).
- Assessments were performed before discharge and during follow-up visits (mean 4 months).
- A prospective study assessed hearing status in 20 patients after antibiotic treatment.
Main Results:
- Overall BAEP impairment was observed in 27.7% of children, with sensorineural hearing loss being most common.
- Hearing impairment was more frequent in bacterial meningitis (34.6%) and aseptic meningitis (20.9%) compared to viral.
- Follow-up BAEP showed that initially abnormal results could normalize, improve, or remain unchanged, highlighting the need for monitoring.
Conclusions:
- The incidence of hearing loss following meningitis in children is substantial.
- BAEP is a valuable tool for early detection and screening of hearing impairment in children with meningitis.
- Regular follow-up BAEP assessments are essential for children with meningitis, particularly those with initial abnormalities.
Abstract:
Brainstem auditory-evoked potential (BAEP) was performed on 101 children with meningitis to assess the incidence of hearing impairment. Fifty-two (51.5%) children had bacterial meningitis, six (5.9%) had viral meningitis, and 43 (42.6%) had aseptic meningitis. Fifty-one (50.5%) patients were assessed before discharge and 50 (49.5%) 9 days to 17 months later (mean = 4 months). BAEP impairment was found in 28 (27.7%) of 101 patients; 24 had sensorineural and four had conductive type of hearing loss, and 17 (60.7%) had unilateral and 11 (39.3%) had bilateral impairment. Hearing threshold was elevated in 22 (21.8%) patients, and the other six had increased latency and interpeak latencies with normal threshold. Frequency of BAEP impairment or hearing loss associated with bacterial meningitis was 34.6% and 30.8%, respectively; frequency associated with aseptic meningitis was 20.9% and 13.9%, respectively. One child with viral meningitis (coxsackie virus) had mild BAEP impairment. Most of the BAEP impairment in the bacterial meningitis group was associated with H. influenzae. Prospective BAEP study was performed in 20 patients randomly at 0.3 to 18 months to assess hearing status after antibiotic treatment, 10 with normal and 10 with abnormal BAEP. All the initially normal BAEP patients remained normal. Of the 10 patients with abnormal BAEP results initially, four returned to normal, two improved, three remained unchanged, and one deteriorated. The incidence of hearing loss after bacterial and aseptic meningitis is high. BAEP is useful to screen for possible hearing loss in children with meningitis, and follow-up BAEP is necessary for those patients with initially abnormal BAEP.
