Central auditory focus in neonatal hyperbilirubinemia using evoked potentials

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Abstract
Increase in bilirubin levels in neonates has been considered a risk factor for sensorineural hearing loss. Recent brainstem evoked potential (BEP) and electrocochleographic studies have suggested that the focus of the lesion is in the brainstem and not in the cochlea for those who have hearing loss. It was consequently postulated that every infant whose bilirubin levels are elevated have at least some temporary auditory brainstem involvement that would be reflected in the BEP waveform. All infants born in the hospital during June, July, and August, 1980 were given BEP testing using clicks at 70 and 30 dB EQSPL. Normal full term babies served as controls. For those infants, at 70 dB, wave I averaged 1.7 ms, wave III averaged 4.7 ms. and V averaged 7.0 ms. Infants with increasing bilirubin levels were recorded at 1/2-day intervals. For all jaundice infants waves III and V increased in latency as the bilirubin level increased. Wave I did not change. Conduction time, between waves III and V was within the normal range, while conduction time betwen wave I and III was abnormal. Since wave I was always normal, hyperbilirubinemia was found to specifically affect wave III which is thought to reflect activity at the second and third synapes in the brainstem. Normal neural function beyond wave III was suggested.

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