Clinical application of brainstem auditory evoked potentials in neonates with hypoxic-ischemic encephalopathy

Objective To evaluate the role of brainstem auditory evoked potential (BAEP) in the diagnosis and prognosis of hypoxic-ischemic encephalopathy (HIE). Methods The HIE clinical grading, BAEP and brain CT scanning were examined and analyzed in 67 neonates with HIE. Forty-one neonates with abnormal BAEP were treated in the early stage and followed up with BAEP and Developmental Quotient (DQ) at 1month, 3 months, 6 months and 1 year of age. Results Of 67 neonates with HIE, 41 had abnormal BAEP (61.19%). The rate of abnormal BAEP was positively related to clinical grading and degree on brain CT scan respectively (χ2 = 21.660, 35.288; P = 0.000, for all). The major differentiation in BAEP among mild, moderate and severe HIE was on abnormal Ⅴ wave (χ2 = 20.659, 27.171; P = 0.000, for all). Compared with brain CT scanning, BAEP achieved a sensitivity of 80.00% (40/50), a specificity of 94.12% (16/17) and a coincidence rate of 83.58% (56/67) in HIE diagnosis. Of 38 treated neonates followed up to 1 year, 9 had abnormal BAEP and were mainly associated with abnormal Ⅴ wave (23.28%), and 12 had abnormal DQ value (31.58%), among which 9 neonates with both abnormal BAEP and DQ value were graded clinically as severe HIE. Conclusion BAEP is a noninvasive, economical, highly sensitive and repeatable method to determine clinical severity and prognosis in HIE neonates.