| Changes in Auditory Brainstem Reponses (ABR) in Severe Hyperbilirubinemic Neonates with Transient Bilirubin Encephalopathy. |
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Chong Woo Bae, Sa Jun Chung, Chang Il Ahn |
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Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea |
| 신생아 중증황달에서 Transient Bilirubin Encephalopathy
환아의 청성뇌간반응 (ABR) 변화에 관한 관찰* |
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배종우, 정사준, 안창일 |
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경희대학교 의과대학 소아과학교실 |
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Received: 19 May 1990 • Accepted: 4 July 1990 |
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| Abstract |
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Many authors have reported alterations in the ABR in severe hyperbilirubinemia and ABR is an
effective non-invasive method of assessing the functional status of the auditory nerve and brainstem
sensory pathway in the management of neonatal hyperbilirubinemia.
Perlman et al reported that jaundice in the early neonatal period is associated with significant
transient aberration of ABR, suggestive of a transient bilirubin encephalopathy (TBE). And they
hypothesized between the time bilirubin enters the CNS and the time that
kernicterus occurs. They called that status as TBE, which was immediate effects of bilirubin on CNS
function and complete reversible and that it is clinically acceptable for bilirubin to be there. TBE is
detected by means of neurophysiolosic probes such as ABR.
This study attempts to evaluate the frequency of TBE in severe hyperbilirubinemic neonates who
were treated by exchange transfusion (ET) and to evaluate the clinical utility of ABR.
Among the total 34 neonates who were treated by ET, seven cases of TBE were appeared (20.6%).
All of seven cases of TBE were under the 7 days of age, and 2 cases were pre-term and 5 cases were
term. According to bilirubin concentration, 2 cases were 20 〜 24 mg/dl, 4 cases were higher than 25
mg/dl.
Among 7 cases, of TBE, abnormal ABR findings were as follows: wave V loss were 6 cases,
prolonged I-III or IPL and low amplitude were 2 cases respectively, and wave III lose was 1 case.
Total 7 cases of TBE revealed the initial abnormal ABR findings to normal level: 6 cases were after
24 hours ET and 1 cases was after 48 hours ET. And they did not showed the abnormal neurologic
examination on regular follow up check.
So, we can suggest the following conclusions: we can apply the term of TBE in neonatal field
especially hyperbilirubinemia of newborn, recordings and findings of ABR are new one part of
criteria for ET and ABR is one of useful diagnostic tool for detecting of bilirubin induced neurotox-
icity. |
| Key Words:
Hyperbilirubinemia of newborn, Transient bilirubin encephalopathy, Auditory brainstem
response |
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