Brainstem auditory and visual evoked potentials in children with protein-energy malnutrition

Background: To determine the effects of malnutrition on the developing brain with brainstem auditory evoked potentials (BAEP) and flash visual evoked potentials (fVEP). Methods: The BAEP and fVEP of 11 kwashiorkor (8+/-1.56 months) and 10 marasmus (7.9+/-1.27 months) patients and 10 healthy control subjects (7.65+/-0.82 months) were recorded and the measurements were compared with each other in relation with plasma total protein and albumin levels. Results: There were no differences between the mean latencies of the waves I, II, III and IV and mean interpeak latencies (IPL) of the waves I-III of the BAEP and the wave IV (N2) of the fVEP between the three groups. Mean latency of the wave V and mean IPL of the waves I-V and the waves III-V were significantly different between the three groups. The kwashiorkor group had significantly longer mean latency of the wave V than the marasmus group on the right ear and the control group on the both of the ears. The kwashiorkor group had significantly longer mean IPL of the waves I-V than the marasmus group on the right ear and than the control group on the left ear. The kwashiorkor group had also significantly longer mean IPL of the waves III-V than the control group on the left. Conclusions: The BAEP and fVEP are non-invasive electrophysiologic methods reflecting the integrity or disruption of the central neurologic pathways. The present results confirm the disruption of the central nervous system with the BAEP in children with protein-energy malnutrition, especially in kwashiorkor patients.