DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20211248

Reversible alteration of brainstem auditory evoked potential in iron deficient anemic patients in response to treatment

Sushant Gupta, Geetanjali Sharma, Sudhir K. Atri, Priyanka Sharma

Abstract


Background: Iron deficiency anemia is associated with central and peripheral nervous system disturbances. Iron is an essential component of brain growth, myelination, nerve impulse conduction, protein synthesis, hormone production, fundamental aspects of cellular energy metabolism and is involved in neurotransmitter synthesis including serotonin, norepinephrine and dopamine. Hence, its deficiency adversely affects motor performance, mental development as well as cognitive and behavioral functions. Since myelination is concerned with conduction in nerve fibers, iron deficiency potentially impairs neuronal transmission and leads to functional neurodeficit like hearing loss.

Methods: BAEP was recorded using RMS EMG EP MK2 machine in patients of iron deficiency anemia with haemoglobin less than 10.9 g/dl between 18-50 years of age who were followed up after 3 months of treatment and compared with 30 age and sex matched controls.

Results: BAEP absolute and interpeak latencies were prolonged in IDA patients as compared to the control groups which was reversible with iron replacement therapy.

Conclusions: Increased absolute and interpeak latencies of BAEP indicates impairment of auditory pathways in IDA patients. Thus, the electrophysiological study of BAEP provides an objective method for monitoring the function of CNS, especially the auditory function in iron deficiency anemia patients before and after iron replacement therapy. It is a non-invasive test for early diagnosis and therefore early treatment to prevent complications.

 


Keywords


Brainstem auditory evoked potential, Central Nervous system, Iron deficiency anemia

Full Text:

PDF

References


Worldwide prevalence of anaemia 1993–2005. WHO Global Database on Anaemia, 2008. Available at: http://whqlibdoc.who.int/publications/ 2008/9789241596657_eng.pdf. Accessed August 12th 2020.

Global Health Risk: Mortality and Burden of Disease Attributable to Selected Major Risks, 2009. Available at: https://apps.who.int/iris/bitstream/handle/10665/44203/9789241563871_eng.pdf?sequence=1&isAllowed=y. Accessed August 12th 2020.

Shankar N, Tandon OP, Bandhu R, Madan N, Gomber S. Brainstem auditory evoked potential responses in iron deficient anemic children. Indian J Physiol Pharmacol. 2000;44:297-303.

Misra UK, Kalita J. Clinical Neurophysiology. 3rd edition. New Delhi: Elsevier. 2014:309-72.

Srireddy SV, Ryan CE, Niparko JK. Evaluation of the patient with hearing loss. In: Lustig LR, Niparko JK, Minor LB, Zee DS. (eds) Clinical Neurotology. London: Martin Dunitz, Taylor & Francis Group. 2003:70-75.

Tandon OP. Average evoked potentials - clinical applications of short latency responses. Indian J Physiol Pharmacol. 1998;42:172-88.

Shankar N, Tandon OP, Bandhu R, Madan N, Gomber S. Brainstem auditory evoked potential responses in iron deficient anemic children. Indian J Physiol Pharmacol. 2000;44:297-303.

Cankaya H, Oner AF, Egeli E, Caksen H, Uner A, Akcay G. Auditory brainstem response in children with iron deficiency anemia. Acta Paediatr Taiwan. 2003;44:21-4.

Kurekçi AE, Sarici SU, Karaoglu A, Ulaş UH, Atay AA, Serdar MA, et al. Effects of iron deficiency versus iron deficiency anemia on brainstem auditory evoked potentials in infancy. Turk J Pediatr. 2006;48(4):334-9.

Algarín C, Peirano P, Garrido M, Pizarro F, Lozoff B. Iron deficiency anemia in infancy: long-lasting effects on auditory and visual system functioning. Pediatr Res. 2003;53:217-23.

Khalifa NM, Awad SA, Elmenshay AA. Neurological Assessment in a Group of Preschool Children with Iron Defficiency Anaemia. J Appl Sci Res. 2009;5(1):103-8.

Sarici SU, Serdar MA, Dündaröz MR, Unay B, Akin R, Deda G, et al. Brainstem auditory-evoked potentials in iron-deficiency anemia. Pediatr Neurol. 2001;24:205-8.

Roncagliolo M, Garrido M, Walter T, Peirano P, Lozoff B. Evidence of altered central nervous system development in infants with iron deficiency anemia at 6 mo: delayed maturation of auditory brain stem responses. Am J Clin Nutr. 1998;68:683-90.