Elkabariti Rasha Hamdi, Khalil Lobna Hamed, Husein Rasha, Talaat Hossam Sanyelbahaa
Department of Otolaryngology, Audiology Unit, Ain Shams University, Egypt.
Department of Pediatrics, Ain Shams University, Egypt.
Int J Pediatr Otorhinolaryngol. 2014 Aug;78(8):1277-80. doi: 10.1016/j.ijporl.2014.05.010. Epub 2014 May 21.
Children with epilepsy are at a considerable risk of cognitive impairment and school failure. Previous studies have typically documented abnormal responses in children with epilepsy at cortical level using speech stimuli. Recent studies reported that abnormal neural encoding of a speech syllable could be detected at the level of the brainstem using speech-evoked auditory brainstem response (ABR). The aim of this study is to investigate speech-evoked (ABR) results in children with epilepsy.
The study group consisted of 38 recently diagnosed epileptic children; none of them has received antiepileptic therapy. They were 22 males and 16 females with age 9.1 ± 3.1 years. The control group consisted of 38 healthy normal hearing children with matched age and gender distribution. All subjects underwent full history taking, basic audiologic evaluation including pure-tone, speech audiometry and immittance testing. Click ABR response was recorded monaurally from both ears at 90 dB nHL then speech ABR was recorded monaurally from each ear at 80 dB SPL.
Though the study group disclosed normal click ABR compared to age matched normative values, speech-evoked ABR revealed a delayed waves V and A latencies in both ears. These findings reflect abnormal neural encoding of speech at the level of brainstem. The younger the age of epileptic child the more prolonged wave A latency and increased V/A inter-latency values.
Speech-evoked ABR results denote abnormal timing in the brainstem; such brainstem abnormality could be detected by speech evoked ABR rather than conventional click evoked ABR.
癫痫患儿存在相当大的认知障碍和学业失败风险。以往研究通常使用言语刺激记录癫痫患儿在皮层水平的异常反应。近期研究报告称,使用言语诱发听觉脑干反应(ABR)可在脑干水平检测到语音音节的异常神经编码。本研究旨在调查癫痫患儿的言语诱发(ABR)结果。
研究组由38名近期诊断为癫痫的儿童组成;他们均未接受过抗癫痫治疗。其中男性22名,女性16名,年龄9.1±3.1岁。对照组由38名年龄和性别分布匹配的健康听力正常儿童组成。所有受试者均进行了全面病史采集、包括纯音、言语测听和声导抗测试的基本听力学评估。在90 dB nHL单耳记录双耳的短声ABR反应,然后在80 dB SPL单耳记录每只耳朵的言语ABR。
尽管研究组与年龄匹配的正常标准值相比,短声ABR正常,但言语诱发ABR显示双耳的V波和A波潜伏期延迟。这些发现反映了脑干水平言语的异常神经编码。癫痫患儿年龄越小,A波潜伏期延长越明显,V/A间期值增加。
言语诱发ABR结果表明脑干存在异常时间;这种脑干异常可通过言语诱发ABR而非传统的短声诱发ABR检测到。