Auditory brainstem responses in sudden infant death syndrome: comparison of siblings, "near-miss," and normal infants.

THE AVERAGED auditory brainstem responses are effectively utilized to determine hearing sensitivity in neonates and infants, ~, 2 and for the detection of brainstem lesions in neuro!ogic disease? In addition, they may also be used as measures of peripheral auditory pathway maturation 4,5 and to monitor the outcome of perinatal asphyxia. 6 Recently, a controversyJhas developed over the condition of the ABR in infants at risk for sudden infant death syndrome. Orlowski et al 7 have described gross abnormalities in ABRs recorded from ten infants who experienced "nearmiss" SIDS episode s, although no attempts were documented to rule out hearing impairment in these infants. Based on these results, Orlowski et al concluded that the ABR has potential as a screening device to identify infants at risk for SIDS, and that the abnormal ABR "implicates the respiratory center and brainstem as the area of dysfunction in SIDS." These statements have been challenged by Gupta et al 8 and by Stockard and Hecox, 9 who examined ABRs in "near-miss" SIDS infants and were unable to replicate the results of Orlowski et al. 7 Siblings of SIDS victims, also considered a high-risk group, 1~ were not included in either of the above studies. The purpose of the present investigation was to examine further the ABR in near-miss SIDS as well as in a group of siblings of SIDS victims; ABR values from both groups were compared to each other and to a control group.