Hostname: page-component-5c6d5d7d68-tdptf Total loading time: 0 Render date: 2024-08-17T22:23:26.092Z Has data issue: false hasContentIssue false

Brainstem auditory evoked potentials after irradiation of nasopharyngeal carcinoma—Report on two cases with myelopathy of the brainstem

Published online by Cambridge University Press:  29 June 2007

S. K. Lau*
Affiliation:
ENT Unit, Department of Surgery, University of Hong Kong.
W. I. Wei
Affiliation:
ENT Unit, Department of Surgery, University of Hong Kong.
D. Choyt
Affiliation:
Department of Radiotherapy and Oncology, Queen Mary Hospital, Hong Kong.
J. S. T. Sham
Affiliation:
Department of Radiotherapy and Oncology, Queen Mary Hospital, Hong Kong.
U. C. G. Engzell
Affiliation:
ENT Unit, Department of Surgery, University of Hong Kong.
*
Mr Sai-kit Lau, ENT Unit, Department of surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong.

Abstract

Brainstem auditory evoked potentials (BAEP) were recorded in two patients with nasopharyngeal carcinoma (NPC) irradiated 14 and three years ago respectively and compared with 15 healthy controls. The patients had features of post- irradiation myelopathy of the brainstem with reduced gag reflex, unilateral vocal cord paralysis and fasciculation of the tongue. The first patient had a blind left eye. The second patient had quadriparesis. All ears revealed post-irradiation otitis media changes and mixed deafness. BAEP was not recognizable in the left ear of the first patient and was normal in the left ear of the second patient. Simultaneous electrocochleogram and BAEP were recorded from the right ear of the first case. The wave I–V latency interval were rolonged in both right ears. In the absence of local recurrence and brain secondaries, these BAEP changes are attributed to the post-irradiation myelopathy of brainstem.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Antonelli, A. R., Bellotto, R., Bertazzoli, M., Busnelli, G. P., Nunez Castro, M., Felisati, G. and Romagnoli, M. (1986) Auditory brain stem response test battery for multiple sclerosis patients: evaluation of test findings and assessment of diagnostic criteria.Audiology 25: 227238.CrossRefGoogle Scholar
Berge, G., Brun, A., Hakansson, C. H., Lindgren, M. and Nordberg, U. B. (1974) Sensitivity to irradiation of the brainstem. Irradiation myelitis in the treatment of a nasopharynx carcinoma. Cancer 33: 12631268.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
Bohne, B. A., Marks, J. E. and Glasgow, G. P. (1985) Delayed effects of ionizing radiation on the ear. Laryngoscope 95: 818828.CrossRefGoogle Scholar
Brown, G. C., Shields, J. A., Sanborn, G., Augsburger, J. J., Savino, P. J. and Schatz, N. J. (1982 a) Radiation retinopathy. Ophthalmology (Rochester) 89: 14941501.CrossRefGoogle ScholarPubMed
Brown, G. C., Shields, J. A., Sanborn, G., Augsburger, J. J., Savino, P. J. and Schatz, N. J. (1982 b) Radiation optic neuropathy. Opthalmology (Rochester) 89: 14891493.CrossRefGoogle ScholarPubMed
Elwany, S. (1985) Delayed ultrastructural radiation induced changes in human mesotympanic middle ear mucosa. Journal of Laryngology and Otology 99: 343353.CrossRefGoogle ScholarPubMed
Gyorkey, J. and Pollock, F. J. (1960) Radiation necrosis of ossicles. Archives of Otolaryngology 71: 793796.CrossRefGoogle ScholarPubMed
Hulcrantz, M. (1985) Structure and function of adult inner ear in mouse following prenatal irradiation. Scandinavian Audiology (Suppl) 24: 124.Google Scholar
Lam, K. S. L., Tse, V. K. C., Wang, C., Yeung, R. T. T.,Ma, J. T. C. and Ho, J. H. C. (1987) Early effects of cranial irradiation on hypothalamic-pituitary function. Journal of Clinical Ednocrinology and Metabolism 64(3): 418424.CrossRefGoogle ScholarPubMed
Lampert, P. W. and Davis, R. L. (1964) Delayed effects of radiation on the human central nervous system; ‘Early and late’ delayed reactions. Neurology (Minneapolis) 14: 912917.CrossRefGoogle ScholarPubMed
Manz, H. J., Woolley, P. V. and Ornitz, R. D. (1979) Delayed radiation necrosis of brainstem related to fast neutron beam irradiation. Case report and literature review. Cancer 44: 473479.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Nightingale, S., Schofield, I. S. and Dawes, P. J. D. K. (1984) Visual, cortical somatosensory and brain stem auditory evoked potentials following incidental irradiation of the rhomben cephalon. Journal of Neurology, Neurosurgery and Psychiatry 47: 9193.CrossRefGoogle Scholar
Robinson, K. and Rudge, P. (1977) Abnormalities of the auditory evoked potential in patients with multiple sclerosis. Brain 100, PTI: 1940.CrossRefGoogle ScholarPubMed
Safdari, G. H. H., Fuentes, J. M., Dubois, J. B., Alirezai, M., Castan, P. and Vlahovitch, B. (1985) Radiation necrosis of brain: time of onset and incidence related to total dose and fractionation of radiation. Neuroradiology 27: 4447.CrossRefGoogle ScholarPubMed
Schuknecht, H. F. and Karmody, C. S. (1966) Radionecrosis of the temporal bone. Laryngoscope 76: 14161428.CrossRefGoogle ScholarPubMed
Selters, W. A. and Brackmann, D. E. (1977) Acoustic tumour detection with brain stem electric response audiometry. Archives of Otolaryngology 103 (4): 8187.Google Scholar
Singh, C. B. and Mason, S. M. (1981) Simultaneous recording of extratympanic electrocochleography and brainstem evoked responses in clinical practice. Journal of Laryngology and Otology 95: 279290.CrossRefGoogle ScholarPubMed
Smith, B. M., McGinnis, W., Cook, J. and Latourette, H. (1979) Central nervous system changes complicating the use of radiotherapy for the treatment of a nasophayngeal neoplasm in a diabetic patient. Cancer 43: 22392242.3.0.CO;2-6>CrossRefGoogle Scholar
Starr, A. and Achor, L. J. (1975) Auditory brainstem responses in neurological disease. Archives of Neurology 32: 761768.CrossRefGoogle ScholarPubMed