DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20150931

Brainstem auditory evoked responses in severely malnourished children

Shashi Kant Dhir, Meenal Batta

Abstract


Background: Severe malnutrition is a common morbidity among children living in slums. The malnutrition affects the development of neural pathways depending on its duration and severity. The effects on both the peripheral and central nervous system by severe malnutrition can be shown using Brainstem Auditory Evoked Response (BAER). The objective of the study was to provide an electrophysiological evidence of effect of severe malnutrition specifically on auditory pathways in brain.

Methods: This study was an observational case control study done in Physiology department of a Government Medical College in north India. This study was done over a period of six months. Thirty children each in the age group of 2-5 years having severe malnutrition (as per WHO classification, Z-score cut-off point of <-3 SD) were taken as cases and thirty age matched children without malnutrition were taken as controls. BAER was done using standard procedures.

Results: Thirty cases and controls each were taken for the study. The mean age of the children in months was 3.18 ± 0.85 and 3.20 ± 0.85 in cases and controls respectively The latencies of all the waves of BAER were found to be significantly increased in children with severe malnutrition as compared to controls (p value <0.05 in all of them). The interpeak latencies of wave I-III and I-V were also found to be increased significantly.

Conclusions: The severe malnutrition leads to the auditory function changes detectable by delayed brainstem auditory evoked responses. These changes could be attributed to defects in myelination in the neural tissue of the auditory pathway.


Keywords


Severe Malnutrition, Brainstem auditory evoked response

Full Text:

PDF

References


Onis M and Monika Blössner M The World Health Organization Global Database on Child Growth and Malnutrition: methodology and applications. International Journal of Epidemiology. 2003;32:518-26.

Mishra UK, Kalita J. Brainstem Auditory Evoked Potential. In : Clinical Neurophysiology, 2nd edition. New Delhi (India): Elsevier. 2011:329-345.

Deorari AK, Garg R, Bisht MS, Ahuja GK, Paul VK, Singh M. Auditory brain stem evoked response in normal neonates and infants. Indian Pediatr. 1989;26(10):981-6.

Wood S Marcormick B, Marson S. Auditorybrainstem response in pediatric audiology.Arch Dis Child. 1988;63:565-7.

Mann N, Sidhu RS, Babbar R. Brainstem auditory evoked responses in different phases of menstrual cycle. J Clin Diagn Res JCDR. 2012;6(10):1640-3.

Vandana null, Tandon OP. Auditory evoked potential responses in chronic malnourished children. Indian J Physiol Pharmacol. 2006;50(1):48-52.

Rubha S andVinodha R. Effects of protein energy malnutrition on auditory evoked potential responses in children International Journal of Current Research. 2015;7(5):16208-11

Chopra JS, Sharma A. Protein energy malnutrition and the nervous system. J Neurol Sci. 1992;110(1-2):8-20.

Hassaan MR, Alghobashy AA, Abdel-Rahman HM. Auditory neural efficiency in protein energy malnourished toddlers with and without iron deficiency anemia. Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2011;12:105-14.

Jane M. Flinn, Ann B. Barnet, Susan Lydick, Johanna Lackner. Infant Malnutrition Affects Cortical Auditory Evoked Potentials. Perceptual And Motor Skills. 1993;76P:1359-62.

Bartel PR, Robinson E, Conradie JM, Prinsloo JG. Brainstem auditory evoked potentials in severely malnourished children with kwashiorkor. Neuropediatrics. 1986;17(4):178-82.

McLaren DS, Burman D. Textbook of pediatric nutrition. Longman Group Limited, 1982.

Odabas D, Mesud ekisli. Brainstem auditory evoked potential responses in children with PEM. International J of otorhinolaryngology. 2005;69(7):923-8

Bass NH, Netsky MG, Young E. Effects of neonatal malnutrition on developing cerebrum. I. Microchemical and histologic study of cellular differentiation in the rat. Arch Neurol. 1970;23(4):289-302.

Wiggins RC, Fuller G, Enna SJ. Undernutrition and the development of brain neurotransmitter systems. Life Sci. 1984;35(21):2085-94.