A to Z of MS Hearing problems

Although hearing loss or deafness is not a common symptom of multiple sclerosis, people can experience problems with hearing, such as tinnitus (ringing in the ears) or sudden hearing loss. Other hearing problems that can occur include the difficulty in discriminating speech against a noisy background or heightened sensitivity to noise (hyperacusis).

MS-related hearing loss can happen suddenly or over the course of a couple of days. Hearing loss does not necessarily mean that you are absolutely unable to hear anything out of one or both ears. It is defined as a loss of at least 30 decibels - this is about half as loud as a normal conversation. Hearing loss usually occurs in one ear only but occasionally both ears are affected.

Because it is an unusual MS symptom, it is important to have other causes of hearing problems ruled out, such as excessive ear wax, medications that can affect your ears, or other illnesses. Hearing loss can also be caused by exposure to loud noise or injury. Referral to an ear, nose and throat specialist or an otolaryngologist may be necessary for a thorough assessment.

In one study of 253 people with multiple sclerosis, only 11 people (4.35%) were found to have experienced sudden hearing loss over 5 years. In 7 of these, it was the symptom that led to their MS diagnosis - suggesting that this symptom tends to occur early in the disease if it is going to occur at all.

Sudden hearing problems can signal an MS relapse, in which case treatment with steroids may speed up recovery of hearing. Hearing problems may also be linked to sensitivity to heat; people experience temporary hearing loss when their body temperature rises, and hearing returns to normal on cooling down.

Hearing problems caused by MS are thought to be due to damage to the brainstem - the part of the brain that is also involved in vision and balance. Problems are often associated with other brainstem symptoms such as tinnitus and vertigo.

In the vast majority of cases of MS-related hearing problems, the symptoms resolve completely, with no residual hearing deficit. In most people, hearing loss does not recur.

References

Cianfrone G, et al
Temperature-dependent auditory neuropathy: is it an acoustic Uhthoff-like phenomenon? A case report.
Annals of Otology Rhinology and Laryngology 2006;115(7):518-527.
abstract

Curé JK, et al.
Auditory dysfunction caused by multiple sclerosis: detection with MR imaging.
American Journal of Neuroradiology 1990;11(4):817-820.
abstract

Hellmann MA, et al.
Sudden sensorineural hearing loss in multiple sclerosis: clinical course and possible pathogenesis.
Acta Neurologica Scandinavica 2011;124(4)245-249.
abstract

Oh YM, et al.
Sequential bilateral hearing loss in multiple sclerosis.
Annals of Otology Rhinology and Laryngology 2008;117(3):186-191.
abstract

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