Abnormal brainstem auditory evoked potentials in infants with threatened sudden infant death syndrome
James P. Orlowski, M.D.
Division of Anesthesiology, Department of Pediatrics and Adolescent Medicine, Pediatric and Surgical Intensive Care
Richard H. Nodar, Ph.D.
Department of Otolaryngology and Communicative Disorders
Derrick Lonsdale, M.D.
Department of Pediatrics and Adolescent Medicine
Sudden infant death syndrome (SIDS) is responsible for approximately 10,000 infant deaths per year in the United States and is the largest single cause of postneonatal infant mortality.1 Several theories of causation have been suggested, one of the most popular of which is that SIDS victims have deficient central control of breathing that predisposes them to life-threatening apneas while asleep.2 The advent of brainstem evoked potential recordings (visual, auditory, and somatosensory) provided a tool for evaluating the integrity of the brainstem in infants with threatened SIDS. Of the three approaches to brainstem evaluation (visual, auditory, and somatosensory), brainstem auditory evoked potential (BAEP) tests are the simplest to perform and most reproducible in infants. This report details our BAEP studies of infants with threatened SIDS.Methods
The ten infants studied were referred to the Cleveland Clinic because of severe, life-threatening apneas. Each infant had had several prolonged episodes of apnea accompanied by cyanosis, which occurred during sleep. Vigorous stimulation or mouth-to-mouth resuscitation was required to revive the infant. Each of the infants was admitted to the Pediatric Intensive Care Unit; and the heart rate, electrocardiogram, and apneic episodes were monitored continuously.
BAEP recordings were performed, analyzed, and plotted using a clinical computer of average transients (Nicolet CA 1000). The stimuli were 100-microsecond clicks presented at a rate of 11.1/sec. Stimulus presentation was at high signal levels of 90 dB HL. Analysis time was 10 msec, sensitivity was set at ± 0.625 μV, and 2000 responses were averaged. Low-pass and high-pass . . .