BRAINSTEM EVOKED RESPONSE AUDIOMETRY (BERA), AUDIOTORY BRAINSTEM RESPONSE (ABR)

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Neurologic objective, noninvasive test of auditory brainstem function in response to auditory (click) stimuli. It’s a set of seven positive waves recorded during the first 10 milli seconds after a click stimuli. They are labeled as I - VII. Also called Jewet bumps.

Healthcare

SPIRAL
GANGLION
COCHLEAR
NUCLEI
SUP OLIVARY
COMPLEX
LATERAL
LEMINISCUS
INFERIOR
COLLICULUS
MEDIAL
GENICULATE
BODY
AUDITORY
CORTEX
DR.GIRISH.S

Processing at different levels
Generates electrical activity
Monitored by surface electrode
Graphic recording presents a waveform with discrete peaks
Depends on the functional integrity of the pathway
DR.GIRISH.S

Click sounds –
stimulates basal part
earlier than apex
Velocity of travelling
wave higher in the
basal part.
BM at base is more taut
& narrow.
Strong neural
synchrony at the basal
part (high frequency
part)
Larger
component of
BERA response.
DR.GIRISH.S

Wave Site of Neural Generator
I Cochlear nerve (distal end)
II Cochlear nerve ( proximal end)
III Cochlear nucleus
IV Superior Olivary Complex
V Lateral Leminiscus & Inferior
Colliculus
VI & VII Not definitely known
DR.GIRISH.S

Parameter measured Normal value (ms) Criteria for
abnormality (ms)
I to III IPL 2 More than 2.4
III to V IPL 2 More than 2.4
I to V IPL 4 More than 4.4
Interaural difference
of wave V
Less than 0.3 More than 0.3
Morphology of wave V Present Absent
DR.GIRISH.S

Large AN arising
from I/L 8th nerve
compressing
brainstem on C/L
side.
DR.GIRISH.S

ECochG is a variant of brainstem audio evoked response (ABR) where the recording electrode is placed as close as practical to the cochlea. We will use the abbreviation ECOG and ECochG interchangeably below. ECOG is preferable to us as it is shorter. ECOG is intended to diagnose Meniere's disease, and particular, hydrops (swelling of the inner ear). ECOG may also be abnormal in perilymph fistula, and in superior canal dehiscence. The common feature connecting these illnesses is an imbalance in pressure between the endolymphatic and perilymphatic compartment of the inner ear. ECOG can also be used to show that the cochlea is normal, in persons who are deaf. The cochlear microphonic of ECOG may be normal in auditory neuropathy (Santarelli and Arslan 2002) as well as other disorders in which the cochlea is preserved but the auditory nerve is damaged (Yokoyama, Nishida et al. 1999). Finally, ECOG's have also been used to as a indicator of the temporary threshold shift that may follow noise injury (Nam et al, 2004).

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BRAINSTEM EVOKED RESPONSE AUDIOMETRY (BERA), AUDIOTORY BRAINSTEM RESPONSE (ABR)

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12. SPIRAL GANGLION COCHLEAR NUCLEI SUP OLIVARY COMPLEX LATERAL LEMINISCUS INFERIOR COLLICULUS MEDIAL GENICULATE BODY AUDITORY CORTEX DR.GIRISH.S

13. Processing at different levels Generates electrical activity Monitored by surface electrode Graphic recording presents a waveform with discrete peaks Depends on the functional integrity of the pathway DR.GIRISH.S

14. DR.GIRISH.S

15. DR.GIRISH.S

16. DR.GIRISH.S

17. DR.GIRISH.S

18. Click sounds – stimulates basal part earlier than apex Velocity of travelling wave higher in the basal part. BM at base is more taut & narrow. Strong neural synchrony at the basal part (high frequency part) Larger component of BERA response. DR.GIRISH.S

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41. Wave Site of Neural Generator I Cochlear nerve (distal end) II Cochlear nerve ( proximal end) III Cochlear nucleus IV Superior Olivary Complex V Lateral Leminiscus & Inferior Colliculus VI & VII Not definitely known DR.GIRISH.S

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73. Parameter measured Normal value (ms) Criteria for abnormality (ms) I to III IPL 2 More than 2.4 III to V IPL 2 More than 2.4 I to V IPL 4 More than 4.4 Interaural difference of wave V Less than 0.3 More than 0.3 Morphology of wave V Present Absent DR.GIRISH.S

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