Volume : 4, Issue : 4, April - 2015

Clinical significance of BERA(Brainstem Evoked Response Audiometry) in children with Sensorineural hearing loss affected by Pyogenic Meningitis and application of BERA in prognosis of hearing loss.

Zafar Iqbal, S C Sharma, S F Hashmi

Abstract :

<p>&nbsp;OBJECTIVE: Sensorineural hearing loss (SNHL) is an important sequelae of acute pyogenic meningitis in children. This&nbsp;</p> <div>study was undertaken to determine the incidence of SNHL following meningitis in non&ndash;neonates and its correlation</div> <div>with various factors. METHODS: Children below age 6 years with ABM admitted in a teaching hospital over a period of 27 months were enrolled.&nbsp;</div> <div>Detailed history was taken, clinical examination performed and cereospinal fluid analyzed at commencement of therapy, 48 hours later and&nbsp;</div> <div>at the end of treatment. On discharge ainstem evoked response audiometry (BERA) was recorded. Data were analyzed using appropriate&nbsp;</div> <div>statistical tests. RESULTS: Out of 75 children enrolled, 45 (60%) developed SNHL, all bilateral, while the rest had unilateral SNHL. Among hearing&nbsp;</div> <div>impaired subjects, 22.2% had mild while 38.85% each had moderate and profound hearing loss. There was significantly higher protein content&nbsp;</div> <div>and neutrophils in the second CSF sample of those with SNHL. Age, presence of vomiting, altered sensorium seizures and aminoglycoside usage&nbsp;</div> <div>were not significantly different in those with and without SNHL, but the total duration of fever was (p&lt;0.05). There was significantly higher&nbsp;</div> <div>protein content and neutrophils in the second CSF sample of those with SNHL. CONCLUSION: There is a greater than 50% probability of the child&nbsp;</div> <div>developing SNHL if neutrophil percentage in the second CSF is 80% or more. Since the overall risk of SNHL is significant in children with meningitis,&nbsp;</div> <div>it is recommended that BERA be recorded in all, so that early intervention may be possible.</div>