Improvement in auditory brainstem response of hyperbilirubinemic infants after exchange transfusions.

Auditory brainstem response tests were performed before and after exchange transfusions in 6 infants with hyperbilirubinemia. The latencies of Waves I, II, and V decreased significantly after the exchange transfusions (p less than .05, p less than .02, p less than .005, respectively) and I-V interpeak latencies also were decreased (p less than .01). However, the latencies of Wave I both before and after exchange transfusions were within normal limits. The central conduction times were prolonged by hyperbilirubinemia, but the peripheral auditory pathways were not impaired. These auditory brainstem response abnormalities became normal with decreased serum bilirubin concentration. Neonatal hyperbilirubinemia is associated with transient brainstem lesions which are reversible in the early stages. Auditory brainstem response testing is an effective and readily available technique for detecting bilirubin neurotoxicity.