Prognostic value of auditory brainstem response for neurologic outcome in patients with neonatal indirect hyperbilirubinemia

To investigate the value of the auditory brainstem response as a reliable t est for the neurologic prognosis. of infants. with neonatal indirect hyperb ilirubinemia, auditory brainstem response studies were performed in 22 infa nts. The patients were followed up until 12 months of age. Two patients dem onstrated pathologic auditory brainstem response consistent with auditory n europathy but had no neurologic finding except a lack of speech at 12 month s of age. Two other patients had neurologic sequelae, one showing severe dy skinetic cerebral palsy, the other mild hypotonia and motor retardation, bu t their auditory brainstem response results were normal. These results sugg ested that auditory brainstem response examination might not provide reliab le information for the neurologic prognosis. Neurologic disturbances result ing from bilirubin neurotoxicity can be seen in patients with a normal audi tory brainstem response, but patients with an abnormal auditory brainstem r esponse may not have any neurologic dysfunction apart from speech retardati on.