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Neurologic Diagnosis
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Brainstem auditory evoked potentials (BAEPs) assess the sequential activation of the brainstem auditory pathway, including acoustic nerve, pons, and midbrain. The patient wears a set of shielded headphones through which a series of clicks (or tones) are delivered 70 dB above hearing threshold and at 11 Hz to one ear, with masking white noise to the other ear. Each click evokes a BAEP.
Neurosurgery: Posterior fossa surgery
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
In contrast to facial nerve monitoring, the role of IONM during acoustic neuroma surgery for hearing preservation is less well defined and less frequently used. However, placement of retractors, tumor dissection and temporal bone drilling during surgery can cause compression of cerebellar tissue which can either involve direct mechanical injury of the cochlea or CN VIII or indirect vascular compromise of the brainstem. According to the recent guidelines by Congress of Neurological Surgeons, intraoperative vestibulocochlear CN monitoring should be used during acoustic neuroma surgery whenever hearing preservation is attempted (47). The most popular techniques for eighth CN monitoring includes BAEP monitoring, electrocochleography, and direct compound nerve action potential monitoring (45). Intraoperative critical BAEP developments, with deterioration or loss, are significant predictors of postoperative hearing function (48).
Brain stimulation: new directions
Published in Alan Weiss, The Electroconvulsive Therapy Workbook, 2018
The brainstem auditory evoked potential (BAEP) measures the functioning of the auditory nerve and auditory pathways in the brainstem. The test is performed with the patient under sedation or under general anaesthesia. A standard broadband monaural click stimulation is used on the ear tested while a masking noise 30 - 40 dB lower in intensity is used on the contralateral ear. The intensity of the click is 65-70 dB above the click perception threshold and click repeated at a rate of about 10 Hz. BEAPS are used in aiding the assessment of hearing loss (Evans, 2014).
Usefulness of intraoperative monitoring in microvascular decompression for hemifacial spasm: a systematic review and meta-analysis
Published in British Journal of Neurosurgery, 2022
Lyndon Sprenghers, Robin Lemmens, Johannes van Loon
64 studies were included in our qualitative analysis. As discussed previously, most studies had a retrospective non-comparative design. The general study characteristics are summarized in Table A of the Supplementary Data. The mean age ranged from 46 years to 58.5 years. 66.1% were women, 50.5% had left-sided spasms. 36 studies reported the duration of spasms before MVD surgery, this ranged from 37 months to 105.6 months. The mean duration of follow-up ranged from one week to 64.8 months. The percentage of loss to follow-up ranged from 0% to 29%, four studies did not report this data. Among the studies about LSR monitoring 37 defined resolution of LSR as complete disappearance, 2 defined it as a decrease in amplitude to less than 50% of baseline and one study did not report a definition. The percentage of patients with immediate postoperative facial palsy ranged from 0.9% to 23%, twelve studies reported this data. The alarm criteria used for BAEP monitoring and the definitions for hearing loss for the studies included in the meta-analysis are summarized in Table B of the Supplementary Data. Most studies reported the maximal deterioration in BAEP monitoring during surgery.
The rare manifestations in tuberculous meningoencephalitis: a review of available literature
Published in Annals of Medicine, 2023
Rong li He, Yun Liu, Quanhui Tan, Lan Wang
The diagnostic method of hearing loss in tuberculous meningoencephalitis depends on hearing examination: that is, to evaluate the patient’s hearing, hearing threshold and hearing function. Brain stem auditory evoked potential (BAEP) is more sensitive to early auditory nerve injury [23]. Cerebrospinal fluid examination and brain MRI enhanced examination are helpful for etiological diagnosis. The patients with tuberculous meningitis showed the above symptoms during the course of the disease. Hearing examination was improved to indicate hearing loss. Except for other diseases, they could be diagnosed.
Influence of malnutrition on the development of the central nervous system of malnourished children
Published in Nutritional Neuroscience, 2020
Rosimar Costa Penido, Myriam Lima Isaac, Alexandre Batista Penido
The brainstem auditory evoked potential (BAEP) is an electrophysiological method used to evaluate the integrity of the auditory pathway. It uses a high, non-variable intensity that allows for the identification of waves and the study of their absolute latency times and the intervals between them, thus identifying possible alterations.9