Early Diagnosis and Evolution of Deafness in Childhood Bacterial Meningitis: A Study Using Brainstem Auditory Evoked Potentials

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Abstract
Children (51) with bacterial meningitis were studied prospectively using serial recordings of brainstem auditory evoked potential (BAEP) from the earliest phase of the disease, according to a standardized protocol. The objectives were to make an early diagnosis and follow th evolution of deafness in the course of meningitis and evaluate the prognostic value of BAEP. Thirty-five children (68.6%) always had normal recordings; 11 children (21.6%) had transient BAEP abnormalities (prolonged wave V latency or elevated threshold for wave I); 5 children (9.8%) has persistent pathologic BAEP recordings from the 1st examination at 48 h until discharge from the hospital and have a persistent deafness. All recordings were normal or pathologic at discharge were confirmed by behavioral audiometry 3 mo. later. These results show the early occurrence of deafness in the course of meningitis with a crucial phase of possible recovery or worsening occurring during the first 2 wk. There were no cases of late deafness or late recovery (there was sometimes slight improvement) occurring after discharge; thus BAEP have a prognostic value. Observation of a child with clinically proven selective high-frequency postmeningitic deficit but without a hearing handicap, a disorder that was diagnosed early with BAEP ( which tests only the high frequencies), is a warning that this method alone is insufficient and that clinical auditory surveillance and conventional audiometry remain necessary.