In auditory brainstem response (ABR) testing, Wave V is generated at which anatomical level and what is its clinical significance?

• A Cochlear nucleus — first obligatory synapse; used to detect retrocochlear lesions
• B Lateral lemniscus — Wave V latency prolongation is the most sensitive indicator of acoustic neuroma and retrocochlear pathology ✓
• C Superior olivary complex — binaural integration; absent in auditory neuropathy
• D Medial geniculate body — cortical auditory processing; absent in cortical deafness

Explanation

ABR Wave V is generated at or near the level of the lateral lemniscus/inferior colliculus transition. It is the most robust and clinically significant wave, and interwave latency prolongation (particularly I–V and I–III intervals) is the most sensitive indicator of acoustic neuroma (vestibular schwannoma) and other retrocochlear pathology. Wave I originates from the distal cochlear nerve, Wave III from the superior olivary complex, and Wave V from the lateral lemniscus. Wave V is used as the threshold wave for objective hearing threshold estimation in newborn hearing screening.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.