People often have physical examinations, which should reveal some problems. For example, whether the brain is working normally, or whether a disease has occurred and should be treated. Everyone's physical condition is completely different, so the test results are also different. Then we should understand the problems found in the brain examination. So is a brainstem evoked potential of 60 normal? The above test results almost always indicate at least moderate hearing loss. The key is to further find the cause of the disease and give active treatment. Hearing aids can be worn to improve hearing. Cochlear implants are not recommended for the time being. They should only be used when hearing is severely impaired. Wearing hearing aids can be said that the baby's hearing may improve, and normal hearing will improve appropriately. Brainstem auditory evoked potential (BAEP) is a relatively sensitive objective indicator of brainstem damage. It is the electrical activity of nerve impulses caused by sound stimulation in the brainstem auditory conduction pathway. It can objectively and sensitively reflect the function of the central nervous system. BAEP records the neural potential activity in the auditory conduction pathway and reflects the functional status of related structures from the cochlea to the brainstem. Any lesions or damage involving the auditory channel will affect BAEP. Often, BAEP changes occur when the brainstem is slightly damaged and there are no clinical symptoms or signs. How to operate BAEP is 6 to 7 positive waves recorded within 10ms after the earphone delivers a short sound stimulus. These waves may have a complex origin at multiple sites, but we can simply assume that wave I is the action potential of the auditory nerve, wave II originates from the cochlear nucleus, wave III comes from the superior olivary nucleus and trapezoidal body of the pons, waves IV and V represent the lateral lemniscus and the inferior colliculus of the midbrain respectively, and waves VI and VII are the action potential waveforms of the medial geniculate body of the thalamus and the auditory radiation. Therefore, waves I and II actually represent the peripheral wave groups of the auditory afferent pathway, and the subsequent waves represent the action potentials of the central segment. The first five waves, wave I to wave V, are the most stable, among which wave V has the highest amplitude and can be used as a sign to identify the waves of BAEP. Under normal circumstances, wave II and wave I, or wave VI and wave VII often merge to form a composite waveform. The wave I latency represents the peripheral conduction time of the auditory pathway, while the inter-wave latency (IPL) of waves I to V is the central auditory conduction time of the brainstem segment, and also represents the integrity of brainstem function. The development of the brainstem auditory conduction pathway is basically consistent with that of other brainstem structures. Therefore, BAEP testing can not only reflect the development of brainstem auditory function but also, to a certain extent, reflect the developmental status of the entire brainstem function. [Data show that the BAEP abnormality rate in children with hypoxic-ischemic encephalopathy is 64.3%, the BAEP abnormality rate in children with language development disorders is 56.6%, the BAEP abnormality rate in children with hyperbilirubinemia is 52.6%, and the BAEP abnormality rate in children with cerebral palsy is 52.4%. If BAEP cannot be elicited, severe damage to the proximal cochlear segment of the auditory nerve may be considered; if the waves of the auditory brainstem evoked potential disappear after wave I or waves I and II, severe damage to the intracranial segment of the auditory nerve or brainstem may be considered. The absolute latency (PL) of each wave of BAEP is prolonged and bilaterally symmetrical. If the IV latency (IPL) is not long, it may be conductive hearing loss until the proximal cochlear segment of the auditory nerve is damaged; if the IV IPL is prolonged, it may indicate that the brainstem auditory pathway is affected. If wave I cannot be elicited but the subsequent waves still exist and the PL is prolonged, the following methods can be used to make a clinical judgment: first, if the III-V IPL is normal, the lesion may occur in the lower part of the brainstem auditory pathway or nerve; second, measuring the conduction time from the negative peak before wave II to the peak of wave V or the negative peak can help distinguish between cochlear lesions and retrocochlear lesions; third, when waves I and III cannot be elicited, the PL of wave V can be observed. If the corrected VPL still exceeds the upper limit of normal, it reveals a retrocochlear lesion. |
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