Bao X, Wong V
Department of Paediatrics, The First Teaching Hospital, Beijing Medical University, PR China.
Pediatr Neurol. 1998 Aug;19(2):109-12. doi: 10.1016/s0887-8994(98)00032-0.
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.
对101例脑膜炎患儿进行脑干听觉诱发电位（BAEP）检查，以评估听力损害的发生率。其中52例（51.5%）为细菌性脑膜炎，6例（5.9%）为病毒性脑膜炎，43例（42.6%）为无菌性脑膜炎。51例（50.5%）患者在出院前接受评估，50例（49.5%）在9天至17个月后（平均4个月）接受评估。101例患者中有28例（27.7%）存在BAEP损害；24例为感音神经性听力损失，4例为传导性听力损失，17例（60.7%）为单侧损害，11例（39.3%）为双侧损害。22例（21.8%）患者听力阈值升高，另外6例阈值正常但潜伏期和峰间潜伏期延长。细菌性脑膜炎相关的BAEP损害或听力损失发生率分别为34.6%和30.8%；无菌性脑膜炎相关的发生率分别为20.9%和13.9%。1例病毒性脑膜炎（柯萨奇病毒）患儿有轻度BAEP损害。细菌性脑膜炎组的大多数BAEP损害与流感嗜血杆菌有关。对20例患者在0.3至18个月时随机进行前瞻性BAEP研究，以评估抗生素治疗后的听力状况，其中10例BAEP正常，10例异常。所有最初BAEP正常患者仍保持正常。最初BAEP结果异常的10例患者中，4例恢复正常，2例改善，3例不变，1例恶化。细菌性和无菌性脑膜炎后听力损失的发生率较高。BAEP有助于筛查脑膜炎患儿可能存在的听力损失，对于最初BAEP异常的患者有必要进行BAEP随访。
