Current concepts on the use of ABR and auditory psychophysical tests in the evaluation of brain stem lesions

Since the inception of the auditory brain stem response (ABR) as a test of brain stem integrity in the mid-1970s, much has been learned about its advantages and limitations. Although ABR remains perhaps the best audiologic test for brain stem disorders, its sensitivity is dependent on the type and various characteristics of the lesion. Behavioral tests, especially interaural timing procedures, also appear to have reasonable sensitivity to brain stem involvement. Results from this type of procedure seem to correlate with certain ABR findings from patients with brain stem lesions. There is support for the concept that carefully selected behavioral tests can complement the ABR and provide increased overall sensitivity for the detection of brain stem dysfunction.