"Negative" ABR findings in an individual with a large brainstem tumor: hit or miss?

This case illustrates the importance of determining the precise locus and extent of a lesion when attempting to correlate lesion site with auditory brainstem response (ABR) findings. The failure to document significant ABR findings in an individual with a large mass involving the low brain stem may initially appear to constitute a threat to the sensitivity of the ABR; however, careful review of the radiologic evidence in this case suggests that sensitivity did not suffer, but rather that the specificity of the procedure was upheld. Moreover, the value of electronystagmography (ENG) in the assessment of an individual with a lesion in the region of the low brain stem and severe vestibular symptoms is demonstrated.