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Eleven cases of acute cerebellar ataxia are presented. The patients were observed during a period of 3½ months in the course of an epidemic of type I poliomyelitis in Puerto Rico. None had typical spinal poliomyelitis. There was evidence that infection with poliovirus type I could have been responsible for clinical findings in nine patients. In two, the symptoms were probably due to a different etiology. The findings suggest an association of acute cerebellar ataxia with infection by poliovirus I. This possibility deserves further investigation.

The deafening effect of high intensity noise is well known—from rock music, aircraft, snowmobiles, motorcycles and the shooting of guns. The effects of hospital noise and its interaction with ototoxic drugs are less well known. The subject is of particular importance to pediatricians, because infants in incubators are exposed to substantial noise from the motor, airflow, respirators, slamming of incubator doors and the baby's own crying. Furthermore, animal experimentation1 shows that the ototoxic drug, kanamycin (often given to the premature infant to combat sepsis), can potentiate the effect of noise on hearing loss as much as 100-fold. Whether or not an interaction between noise and potentially ototoxic drugs occurs in man is as yet unknown. MEASUREMENT Noise has frequency and intensity. Frequency is measured in cycles per second, designated hertz (Hz). The young human ear is sensitive to a frequency range of 20 to 20,000 Hz. White noise, the auditory counterpart of white light, has equal energy in each frequency in the audible range. Intensity is measured in decibels on a scale which is linear with respect to audible frequencies. This measurement is designated dB (linear). Since the human ear is more sensitive to the damaging effects of high frequency sound than to low frequency, a better correlate with noise-induced hearing loss can be obtained when low frequencies are filtered out. Filtered sound level, measured on a so-called A-weighted scale, is designated dB(A). Room conversation produces 60 to 70 dB(A), rock music 100 to 120 dB(A) and snowmobiles 105 to 135 dB(A) for the driver.

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