Clinical and pathologic correlates of brain stem auditory response abnormalities

TLDR

Short‑latency auditory evoked responses were recorded in over 100 neurologic patients, with abnormalities correlated to postmortem or radiologic localization of brain‑stem lesions, and serial recordings tracked lesion evolution and response to therapy. The study mapped waves I–VII to specific auditory‑pathway levels and showed that using these response abnormalities prospectively can detect and localize brain‑stem lesions that other tests miss.

Abstract

Short-latency auditory evoked responses were recorded in over 100 neurologic patients. Abnormalities of each response component were correlated with postmortem or radiologic localization of different brain stem lesions. These findings suggested that waves I-VII largely reflect activity at the following levels of the auditory pathway: acoustic nerve (I), pontomedullary junction (II), caudal pons (Ill), rostral pons or midbrain (IV), midbrain (V), thalamus (VI), and thalamus or auditory radiation (VII). When this information was applied prospectively to the evaluation of brain stem dysfunction, response abnormalities proved useful in detecting and localizing certain lesions not revealed by other tests. Serial recordings provided information about the evolution of brain stem lesions and their response to therapy.