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Brainstem auditory evoked potentials are normal in idiopathic sleep apnea.

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Brainstem Auditory
Evoked Potentials Are
Normal in Idiopathic
Sleep Apnea
Dean Karnaze, MD," Peggy Gott, PhD,'
Frank Mitchell, R EEG T,"
and James Loftin, M D t
We studied brainstem auditory evoked potentials (BAEPs) in
18 patients with sleep apnea (7 central, 5 mixed, 6 obstructive) to assess the normality of the BAEPs and to compare
the I-V interpeak latency (IPL) to that of controls.
Eighteen apneic patients (mean age, 50.7; 17 male and 1
female) were studied during the waking state. Forty-nine persons with normal audiological examination findings served as
controls. These were divided into three groups, those less
than 50 years of age (33 subjects, 15 male and 18 female),
those above age 50 (16 subjects, 11 female and 5 male), and
those who were male (20 subjects). Mean ages for these
groups were 29, 65.3, and 39.3 years, respectively. Two
thousand forty-eight ten-per-second 60 dB SL rarefaction
clicks were applied to each ear of the controls independently
(white noise applied to contralateral ear), and responses were
averaged by a PDP 8/F computer for 10 ms (amplification, 2
x lo5; band pass, 100 Hz to 3 kHz). Responses were recorded between Cz and the ipsilateral mastoid.
The upper limits (mean plus 2.5 standard deviations) for
the young, old, and male control groups of the I-V, 1-111,
and 111-V IPLs, respectively, were: I-V, 4.55,4.69,4.68 ms;
1-111, 2.5, 2.8, 2.8 ms; and 111-V, 2.3, 2.4, 2.33 ms.
Similar methods were applied to the apneic patients, except that clicks were applied at 60 to 65 dB SL.
Only one apneic patient, with central apnea resulting from
meningeal leukemic infiltration, had a central BAEP abnormality. This parient showed prolongation of the I-V (4.8
ms), and the 1-111 IPL (2.72 ms) was near the upper limits of
normal, indicating a disturbance of the auditory pathways,
406 Annals of Neurology
Vcil 15 No
4 April 1984
Tracings from a 56-year-o/d man with central sleep apnea ULquired from meningeal injiltration by chronic lymphocytic
leukemia. The right 1-V interpeak latency (IPL) is ProLonged
14.8 ms), and the right I - I l l IPL is at the upper limits for age.
most likely at a right upper medullary to low pontine level
The mean I-V IPL of the sleep apneic patients, not including the one with abnormal BAEPs, did not differ significantly
from those of the young, old, or male control group i p
0.05). The mean I-V IPLs for right and left ear stimulation
combined were 4.06 ms; those for the young, old, and male
controls were 4.04,4.14, and 4.16 ms, respectively.
This study, in agreement with previous studies [I, 21, indi-.
cafes that central BAEP disturbances are rare in idiopathic
sleep apnea and shows that the I-V lPLs of apneic individuals
do not differ significantly from those of controls. When
BAEP abnormalities are found in such patients, one should
search for a specific brainstem or meningeal lesion.
Presented in part at the meeting of the American Electroencephalographic Society, New Orleans, LA, Oct 21, 1983.
The authors thank Dr E. Phillips for referring many of the patients,
and Elaine OConnor for technical assistance.
Departments of "Neuvology and fPulmonaq Medicine
Los Angeles County-Univer.rit.y of Southern Culifornia
Medical Center
Los Angeles, CA 9003?
1. Mosko S, Pierce S, Holowach J , Sassin J E : Normal brainstem
auditory evoked potentials recorded in sleep apneics during waking and as. a function of arterial saturation during sleep. Electroencephalogr Clin Neurophysiol 5 1:477-482, 138 1
2. Peled R, Pratt B, Scharf B, Lavie P: Auditory branstem evoked
potentials during sleep apnea. Neurology (Cleveland) 33.4 19-423, 1383
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potential, idiopathic, apnea, auditors, sleeps, brainstem, norman, evoked
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