What is the role of brainstem auditory evoked response (BAER) testing in the workup of Haemophilus influenzae type b (Hib) meningitis?

Updated: Jul 09, 2018
  • Author: Prateek Lohia, MD, MHA; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Hearing impairment is a common complication in Hib meningitis. It is usually permanent. Hearing may be difficult to assess clinically; therefore, all children should have BAER testing at some point during hospitalization or in the early period of posthospitalization recovery.

The results of BAER testing do not influence acute management, and to that extent, the timing of BAER testing is not important. However, the value of BAER testing in predicting permanent sensorineural hearing loss from bacterial meningitis is limited if test results are abnormal before resolution of conductive loss (due to the presence of otitis media, which frequently precedes Hib meningitis) or other possible forms of acute inflammation of neural tissue. Thus, the test should be repeated some weeks or months later if results are initially abnormal.

On the other hand, if the test results are normal during the acute phase of the disease, their predictive value for normal hearing is excellent. Unlike other focal complications of meningitis, sensorineural hearing loss is not a risk factor for epilepsy. However, sensorineural hearing loss is associated with language and learning delays. Thus, if present, children should be referred for further hearing and speech evaluations and therapies.


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