Choosing the objective test: sleeping infant versus awake adult
Vignette
Two patients are booked the same morning: a 3-month-old who will be tested during natural sleep, and a 30-year-old who cannot give reliable behavioural responses due to severe tinnitus and anxiety but is fully awake and cooperative. Both need frequency-specific objective thresholds.
Findings
The cortical response is large and clear in the awake adult, but would degrade markedly if the patient were asleep.