Evaluation of brainstem auditory evoked potential in assessment of brain impairment of children with severe hand-foot-mouth disease

Objective To investigate the value of brainstem auditory evoked potential for assessment of brain impairment of children with severe hand-foot-mouth disease ( HFMD) . Methods Patients with HFMD treated in Guangzhou Women and Children Medical Center from August 2010 to December 2012,were recruited and divided into severe illness group and intensive care group according to their status. Patients with HFMD but with no neurological involvement in hospital at the same time were defined as the control group. Brainstem auditory evoked potential was measured on the day of admission for all patients and the fourteenth day after onset for severe illness group and intensive care group. The change of brainstem auditory evoked potential was examined and evaluated by the reaction threshold and Hall's grading. F test and χ 2 test were performed using SPSS 17. 0. Results Four hundred and twenty-three cases with HFMD were enrolled into the study including 121 cases in the sever illness group,102 cases in the intensive care group and 200 cases in the control group. Brainstem auditory evoked potential examination identified 34 abnormal patients in the sever illness group,49 in the intensive care group,none of abnormal cases in the control group. The increased reaction threshold value of brainstem,the delayed peak latencies ( PL) of wave Ⅲ,the decreased wave amplitude of Ⅲ or Ⅴ wave,were significantly different among the three groups. The reaction threshold value of brainstem and Hall 's grading were evidently decreased in the severe illness group and intensive care group after treatment. Conclusion In the brainstem impairment due to HFMD,brainstem auditory evoked potential showed mainly the increased reaction threshold value of brainstem,the delayed peak latencies ( PL) of wave Ⅲ,the decreased wave amplitude of Ⅲ or Ⅴ wave. The reaction threshold value of brainstem and Hall's grading can be used to evaluating the change of brainstem auditory evoked potential,it is helpful to assess the progress of brainstem impairment of the children with HFMD.