PEDIATRICS Vol. 77 No. 6 June 1986, pp. 928
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Auditory Testing and Bilirubin

STEVEN M. SHAPIRO MD1 and KURT B. HECOX MD, PHD1

1 Department of Neurology, University of Wisconsin, Waisman Center on Mental Retardation and Human Development, 1500 Highland Ave, Madison, WI 53705-2280

To the Editor.—

Nakamura et al (Pediatrics 1985;75:703-708) provide a useful correlation of the auditory brainstem response (ABR) with unbound bilirubin levels. However, their findings of normal I-V interwave intervals despite increased wave I latencies are surprising in light of other reports of increased interwave intervals in neonates with hyperbilirubinemia. Their suggestion that with bilirubin toxicity alone "brainstem function probably is not involved" contradicts other studies of hyperbilirubinemic neonates that have found central (brainstem), in addition to peripheral, auditory brainstem response abnormalities.