Brain-stem auditory-evoked responses.
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Biomedical subjects
Publications and source records attributed to J E Stockard.
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Brainstem auditory-evoked responses (BAERs) were elicited from 64 neurologically and audiometrically normal adults and 77 normal, full-term neonates with broadband rarefaction or condensation clicks at sensation levels (hearing levels in neonates) of 30 to 70 dB and at rates of ten and 80 clicks per second. In addition to the known effects of rate, previously unrecognized effects of acoustic phase and stimulus intensity on BAER interpeak latencies (IPLs), and an interaction of all three stimulus parameters, were found. Stimulus characteristics, age, and sex can account for much of the inter- and intrasubject variability of BAER IPLs and morphology. The BAER effects of many of these variables and their interactions have not been appreciated in clinical applications of BAER. Recognition and control of such reducible, methodological sources of BAER variability will enhance the sensitivity and specificity of the test in neurologic diagnosis.
Seven vertex-positive potentials--the brainstem auditory response--can be recorded from the human scalp within 10 milliseconds of an appropriate acoustic stimulus. The first of these potentials is generated in the acoustic nerve, the third in the pons, and the fifth in the midbrain. Measurement of the relative latencies and amplitudes of these potentials allowed detection of subclinical lesions in 37 (53 percent) of 70 patients with suspected multiple sclerosis who had no signs or symptoms of brainstem involvement by the disease. Abnormalities in the brainstem auditory response provided the first evidence of the pressence of multiple lesions in 14 (35 percent) of 40 patients with suspected multiple sclerosis who had clinical evidence of only a single spinal or cerebral lesion. Response abnormalities also suggested the presence of tumors of the posterior fossa in three patients with nonspecific symptoms and normal neurologic examinations, the test indicated the need for contrast studies, which then led to the correct diagnosis of infratentorial neoplasm.