How Hearing Problems and Multiple Sclerosis Are Related

Sudden Hearing Loss or Ringing in the Ears Can Be Symptoms of MS

Doctor examining ear of patient in clinic. Credit: Jose Luis Pelaez Inc / Getty Images

People with MS can experience problems with hearing, such as tinnitus (ringing in the ears) or sudden hearing loss, although it is not a common symptom of multiple sclerosis. 

In fact, because it is so rare to occur as an MS symptom, it is important to have other causes of hearing problems ruled out, such as excessive ear wax, medications that can harm your ears (ototoxic drugs), Ménière's disease or other illnesses, or tumors.

Clearly, hearing loss can also be attributable to exposure to loud noise or injury.

That being said, in a study of 253 people with multiple sclerosis, only 11 people (4.35%) were found to have experienced sudden hearing loss over 5 years. In seven of these patients, it was the symptom that led to their MS diagnosis — researchers think it tends to occur early in the disease if it is going to occur at all.

At least one case has been described linking hearing problems to Uthoff's phenomenon — usually associated with vision problems, meaning that the person experienced temporary hearing loss when her body temperature rose, but her hearing returned to normal when she cooled down.

Tinnitus is also pretty rare as an MS symptom, with individual cases reported in the medical literature.

What Causes MS-Related Hearing Problems?

Sudden hearing problems can signal an MS relapse. They can also be related to heat exposure.

 In some of the cases that have been studied, it seems that MS lesions in the auditory pathways were responsible for the hearing problems. However, some people with tinnitus or hearing loss and MS do not have lesions in the auditory pathways, but in the white matter around the ventricles or in other locations.

The most common of MS-related hearing problems are sudden hearing loss and tinnitus.

Sudden Hearing Loss: In many cases of MS-related hearing loss, the impairment tends to be sudden and pretty dramatic, meaning that it can happen all at once or over the course of a couple of days, differentiating it from age-related hearing loss, which develops gradually.

In the majority of people with MS who experience hearing loss as an MS symptom, it is unilateral — only occurs in one ear. However, there are rare cases of both ears being affected.

Sudden hearing loss does not necessarily mean that one is absolutely unable to hear anything out of one or both ears. It is defined as a loss of at least 30 decibels – this number can be understood as about half as loud as a normal conversation.

Tinnitus: While many people think of tinnitus as "ringing in the ears," it can also sound like whistles, clicks or murmurs. It can be very loud (enough to interfere with hearing) or it can just be a light background noise.

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.

The Takeaway

While rare, hearing problems can be a symptom of MS.

If your neurologist just shrugs and says that your sudden hearing problems have nothing to do with your MS, you can agree to see an ear, nose and throat specialist (ENT or otolaryngologist) to rule out other causes.

However, if the ENT cannot find anything wrong, your neurologist should follow up with an MRI. It is possible that you are having a relapse that can be shortened with a course of Solu-Medrol.

It is also important to remember that sudden hearing loss and tinnitus tend to resolve in most people, regardless of the cause.


Cianfrone G, Turchetta R, Mazzei F, Bartolo M, Parisi L. Temperature-dependent auditory neuropathy: is it an acoustic Uhthoff-like phenomenon? A case report. Ann Otol Rhinol Laryngol. 2006 Jul;115(7):518-27.

Curé JK, Cromwell LD, Case JL, Johnson GD, Musiek FE. Auditory dysfunction caused by multiple sclerosis: detection with MR imaging. AJNR Am J Neuroradiol. 1990 Jul-Aug;11(4):817-20.

Hellmann MA, Steiner I, Mosberg-Galili R. Sudden sensorineural hearing loss in multiple sclerosis: clinical course and possible pathogenesis. Acta Neurol Scand. 2011 Jan 4.

Oh YM, Oh DH, Jeong SH, Koo JW, Kim JS. Sequential bilateral hearing loss in multiple sclerosis. Ann Otol Rhinol Laryngol. 2008 Mar;117(3):186-91.

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