AUDITORY EVOKED POTENTIALS AND VISUAL EVOKED POTENTIALS: A HELPFUL TEST IN THE DIAGNOSIS AND FOLLOW UP OF KAWASAKI DISEASE

Introduction: Kawasaki disease is a systemic vasculitis affecting mainly children; the most serious complications are coronary artery lesions (CAL). Nonetheless, the spectrum of complications involves all the vascular districts, such as the eyes, skin, kidneys, gallbladder, liver, central nervous system. Sensorineural hearing loss is a low diagnosed complication of KD, however, it may be permanent. Objectives: Auditory evoked potentials (ABR) and visual evoked potentials (VEPs) are useful in evaluating children without auditory and/or visual symptoms but with diseases that could sub clinically involve these functions. Methods: We enrolled 52 children (31 M, 21 F; age: 3 months-10 years) with KD and evaluated ABR and VEPs in the acute phase of the disease and during the follow up. We correlated the neurophysiological study with clinical, biochemical parameters, the type of KD (typical, atypical, incomplete) with cardiac involvement and time of IVIG and/or other non-conventional treatment in the acute phase of KD. Results: VEPs were pathological in 6 children (4 M; 2 F) (1 patient with CAL had monoliteral alterations; 2 patients had ABR pathological as well). ABR were pathological in 36/52 patients (69%) (2 patients without CAL had monoliteral alterations). Furthermore, in those patients (31M; 21 F) there were no significant differences in age, time of the diagnosis, time of the first dose of IVIG, biochemical parameters (leukocytes, neutrophils percentage, AST, ALT, gamma-GT, albumin, Na, fibrinogen, D-Dimer) vs KD patients without alterations of ABR and VEPs.One patient showed a persistent sensorineural auditory loss. During the follow up, ABR and/or VEPs alterations persisted in the 80% of the patients. Most of the patients showed alterations of the wave V and the I-V, expression of mesencephalic involvement. Conclusion: We suggest evaluating ABR and VEPs in patients with KD, both in patients with precocious diagnosis and treatment either in children treated later than 10 days with IVIG. We suggest studying also patients without CAL, in whom neurophysiological study may contribute to the complete follow up of these patients.