Table 6.
BAEP waves | Anatomic localization |
I | Distal portion of the auditory nerve |
II | Proximal portion of the auditory nerve or cochlear nuclear complex, in the upper part of the medulla, ipsilateral to the stimulation side |
III | Cochlear nucleus or superior olivary complex in caudal pontine tegmentum, ipsilateral to the stimulation side |
IV | Superior olivary complex (lateral lemniscus), contralateral to the stimulation side |
V | Inferior colliculus located in the midbrain, contralateral to the stimulation side |
Blink test | Response |
After stimulation of the supraorbital nerve, three responses are recorded on eyelid orbicular muscles: an early ipsilateral (R1) response and the two (ipsi- and contralateral) late responses (R2) | R1 response generated at the level of the pons, R2 responses at the level of the trigeminal-spinal tract at the pons level, the medulla oblongata, and the caudal trigeminal-spinal nucleus |
Brainstem lesions can result in absent or delayed peaks III and V, prolonged III–V and I–V inter-peak latency, or a reduced I/V amplitude ratio (< 0.5)
Delay or absence of R1 indicates a facial /trigeminal nerve injury. R2 can be delayed in comatose patient and is also bilaterally delayed or absent in Wallenberg’s syndrome (with a R1 preserved)