Progressively Recovering Auditory Brainstem Response in a Cochlear-implanted Child After Meningitis: A Case Report

Objective: I describe the case of an 8-year-old boy who developed meningitis several years after implantation and how electrically evoked auditory brainstem response (EABR) is used in the assessment of his hearing performance after recovery. Patient: An 8-year-old boy stopped using both his cochlear implants because of streptococcal meningitis accompanied with acute otitis media on the left ear. After recovery his hearing was quickly restored on the right ear, but he complained of not hearing well on the left ear. Intervention: Diagnostic. Main Outcome Measure: EABRs were measured on both ears 2 months after meningitis offset. Testing was repeated on the left ear 12 and 18 months after the first session. Responses were evoked by apical, mid-array, and basal electrodes. Results: At initial testing EABRs were normal on the right ear. They were absent on the left ear for the apical electrode and present but with delayed wave latencies for the middle and basal electrodes. At the second and third sessions, EABRs were present for all electrodes and wave eV latencies were shorter. The stimulus level needed to evoke an EABR was considerably reduced on all electrodes from the first to the third session. There was good agreement between these findings and the subjective feedback from the patient. Conclusion: EABR provided valuable information throughout the patient's hearing recovery. Its use should be considered in difficult patients, especially those who cannot give feedback.

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