Clinical significance of BERA(Brainstem Evoked Response Audiometry) in children with Sensorineural hearing loss affected by Pyogenic Meningitis and application of BERA in  prognosis of hearing loss.

Volume : IV, Issue : IV, April - 2015

Zafar Iqbal, S C Sharma, S F Hashmi

OBJECTIVE: Sensorineural he� loss (SNHL) is an important sequelae of acute pyogenic meningitis in children. This

study was undertaken to determine the incidence of SNHL following meningitis in non–neonates and its correlation

with various factors. METHODS: Children below age 6 years with ABM admitted in a teaching hospital over a period of 27 months were enrolled.

Detailed history was taken, clinical examination performed and cereospinal fluid analyzed at commencement of therapy, 48 hours later and

at the end of treatment. On discharge ainstem evoked response audiometry (BERA) was recorded. Data were analyzed using appropriate

statistical tests. RESULTS: Out of 75 children enrolled, 45 (60%) developed SNHL, all bilateral, while the rest had unilateral SNHL. Among he�

impaired subjects, 22.2% had mild while 38.85% each had moderate and profound he� loss. There was significantly higher protein content

and neutrophils in the second CSF sample of those with SNHL. Age, presence of vomiting, altered sensorium seizures and aminoglycoside usage

were not significantly different in those with and without SNHL, but the total duration of fever was (p<0.05). There was significantly higher

protein content and neutrophils in the second CSF sample of those with SNHL. CONCLUSION: There is a greater than 50% probability of the child

developing SNHL if neutrophil percentage in the second CSF is 80% or more. Since the overall risk of SNHL is significant in children with meningitis,

it is recommended that BERA be recorded in all, so that early intervention may be possible.