Unexplained Hearing Loss in 8 Month old....Neurologist completel puzzled.

[Cheyenne_08]

My 8 month old son had an MRI and BAER because he has an abnormal auditory response. The history is at 4 months Ashtyn was not tracking and so the opthamologist wanted him to see a neurologist to have an MRI to determine if he was neurologically blind. The neurologist said it was NOT his eyes, and said he was hearing impaired. He said this because he used tuning forks, snaps, claps, and a lot of other VERY loud noises to get Ashtyn's attention and only one time during this did Ashtyn even blink. He in NO way showed that he heard the sound and made no attempt to try and find it. SO....the BAER just came back that my son is hearing within normal range and has no hearing loss. and the MRI found slight damage to the area of the brain that causes a person to neglect visual stimuli but he said that in NO way explains why Ashtyn does not respond to sound. One day I might say his name and he will look right at me, but another day I can yell, scream, bang things together and Ashtyn does not even blink or pay any attention at all.

The neurologist said this is NOT a normal auditory response but the MRI and BAER showed no explaination for this!  He is repeating the MRI and BAER in 6 to 10 months. He had blood tests and urine tests done, looking at EVERY thing including DNA mutations and chromosomes. THey all found nothing. I am stressed to the MAX and can not figure out why sometimes I know Ashtyn can hear and sometimes he appears completely deaf. No test is telling us why this is, to the point that a pediatric neurologist is confused! Anyone experience this or have ANY ideas as to what it could be??? Please Help!

[Cheyenne_08]

Forgot to meantion that Ashtyn was born at 31 weeks gestation with the cord around his neck 6 times. THe damage to his brain may have been caused by prematurity so the neurologist is waiting to see if the brain repairs itself.

[Wear/a/Jimmy]

OK here is the deal. I have a doctorate in Audiology....  so the source is good.

Sadly, often times you have ENTs that have a person with zero training running the BAER tests... so be careful.

If you were working with me, this is what I would request:

1) Sedation (Hydro Chloride) same thing used by dentist use
2) Tympanometery
3) DPOAE diagnostic testing
4) ASSR

BAER is old technology that will not give as complete information as an ASSR. Basically if you asked to know how tall a person is, and measured that person's toe....  the toe measurement gives you an estimation of the person's height... at best.  That is what an BAER essentially does.

The ASSR gives you a complete measurement.

DPOAE testing will determine cochlear function (inner ear)

Tympanometry will determine the middle ear status (fluid, normal movement etc)

If your ENTs offer you less than the above, you are working with a group that rely on old technology, and techniques. If it were my child, I would not accept anything less than the best.

BARE studies and ASSR studies cost exactly the same.

I wish you the best, and feel free to post more questions, and insist on working with a licensed audiologist..... period. There are absolutley no other individuals as trained as they are in the area of hearing diagnostics. PERIOD

[Wear/a/Jimmy]

Correction: Hydro Chlorate = Chloral Hydrate

http://en.wikipedia.org/wiki/Chloral_hydrate

BARE = BAER

ASSR will give a complete measurement, but will not give you a cognitive measurement. Meaning, it can not test to determine if your child can hear and cognate, decipher a sound. It will only tell you if the brain is recieveing acoustic stimulus, but it will not tell you what the brain is doing with the stimulus....

that about sums things up.

Good luck, and I do hope you find a facility that if fully equiped with both the staff and the diagnostic machines to handle your child's case.

[Cheyenne_08]

Ashtyn's tests were done by the head of the Audiology Department at the Toledo Children's hospital. She did all the tests you described and found fluid behind the right ear. He was sedated because he had just completed his MRI. So, all the tests showed nothing, but he is clearly not responding to sound. Could it be an auditory processing disorder because his neurologist did meantion that, but said there was nothing that could be done until he was 6-8 years old!!!!

[Wear/a/Jimmy]

Well if fluid was found....  and they did not have bone ABR equipment, and the probably did not, because the equipment is extremely rare....  then the results really do not mean anything.

In other words the test is based on an acoustic stimuli, the stimulus must travel through the ear canal, middle ear unabated....  sound can not travel through the fluid that is being held within the middle ear. So for the test results to be accurate you most perform a bone ABR (bone BAER) or have a normal middle ear.

Like I was saying bone BAER equipment is extremely rare, I have never seen it in use, nor have I ever sold the equipment, nor have I ever had a customer asked to buy that equipment. Why is it never sold? Added costs, I guess.

But this information only applies to your childs right ear. If the left ear middle ear function was normal, and test results were abnormal.... then that is reliable.

I would say, have more testing done, if all of those result are consistent...  do not wait until your child is 6-8 years old to intervene. You need to investigate cochlear implants, deaf culture, sign language etc. You yourself need to get prepared and armed with information. If you wait until your child is 6-8 years old for solid information.....  that would be a disaster.

[Cheyenne_08]

Thank you. My neurologist is making my son an appointment at the University of Michigan for a second opinion.