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SAT0513 Brainstem Auditory Evoked Potentials and Visual Potentials in Kawasaki Disease: Expression of CNS Vasculitis?
  1. M.C. Maggio1,
  2. C.M. Ministeri2,
  3. I. Maccora1,
  4. G. Vitaliti1,
  5. E. Prinzi1,
  6. G. Corsello1
  1. 1ProSaMI, University of Palermo
  2. 2U.O.S. of Neurophisiopathology, Ospedale Civico, Palermo, Italy

Abstract

Background Kawasaki disease (KD) is an acute, self-limited vasculitis of infants and children that is nowadays the most common cause of acquired heart disease in children.

Transient sensorineural hearing loss (20 to 35 dB) is a possible complication of acute phase KD and may be related to salicylate toxicity in some patients.

Objectives Brainstem Auditory Evoked Potentials (BAEPs), and Visual Evoked Potentials (VEPs) were examined in 43 children (age: 0,8-7,5 years) affected by KD. No risk factors for hearing loss and/or neurological impairment of CNS were identified in all the patients.

BAEPs showed altered waves II to V, in 18 patients (42%). Among these, in 4 patients (20%) VEPs showed altered waves.

Results The 18 patients with altered waves of BAEPs were 11 with typical KD, 7 with incomplete KD. Among the 11 patients with altered BAEPs and typical KD, 36% showed coronaritis; among the 7 patients with altered BAEPs and incomplete KD, 57% showed coronaritis.

The evaluation of waves VI, VII, interpeak latency V-VII were performed in all the patients and showed a pathological pattern in 72% of altered BAEPs, but also in 68% of patients with normal waves I to V. These waves are expression of neuronal conduction in medial geniculate, acoustic radiations, sign of a lesion of mesencephalon, thalamus and/or acoustic radiations.

No correlation was relieved with EVIG doses, days of fever at the start of EVIG, pre-EVIG D-Dimer plasmatic levels, CRP, ESR, leukocytes, neutrophils percentage pre- and post- EVIG.

Conclusions Altered BAEPs waves are relieved in 81% of KD patients; 70% of KD patients showed altered VI, VII and/or V-VII expression of CNS vasculitis of mesencephalon, thalamus and/or acoustic radiations. Despite normal hearing acuity these children showed a vasculitis of CNS, in 43% of them coronaritis was associated.

References

  1. Knott PD, Orloff LA, Harris JP, Novak RE, Burns JC; Kawasaki Disease Multicenter Hearing Loss Study Group. Sensorineural hearing loss and Kawasaki disease: a prospective study. Am J Otolaryngol. 2001;22(5):343-8.

Disclosure of Interest None declared

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