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Lateralization of brainstem lesions by brainstem auditory evoked potentials

From the Departments of Neurology (Drs. Oh, Kuba, Soyer, Choi, and Bonikowski) and Diagnostic Radiology (Dr. Vitek), The University of Alabama in Birmingham, School of Medicine, Birmingham, AL.

In eight patients with unilateral pontine and midbrain lesions, brainstem auditory evoked potentials (BAEPs) were studied with ipsilateral (Cz-Ai) and contralateral (Cz-Ac) recordings after monaural stimulation. In all cases, the most prominent abnormality was noted in BAEP generated by stimulating the ear ipsilateral to the lesion. The Cz-Ai and Cz-Ac patterns showed similar abnormalities in five of the patients and dissociated abnormalities in two patients. We conclude that: (1) Lateralization by BAEP is possible in unilateral pontine and midbrain lesions. (2) Monaural stimulation with Cz-Ai and Cz-Ac recordings is essential for lateralization. (3) The BAEP in monaural stimulation is predominantly generated from the auditory structures ipsilateral to the stimulated ear.

Address correspondence and reprint requests to Dr. Oh, Department of Neurology, The University of Alabama in Birmingham, School of Medicine, Birmingham, AL 35294.

Accepted for publication April 4, 1980.

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