Hearing Problems and Multiple Sclerosis

Sudden hearing loss or ringing in the ears can be symptoms of MS.

Hearing Problems May Be a Symptom of Multiple Sclerosis
Hearing Problems May Be a Symptom of Multiple Sclerosis. Mike Kemp/Getty Images

People with multiple sclerosis can and do experience hearing problems—just like people without MS. The trick is figuring whether a new hearing problem is or is not related to your MS. Hearing problems that are sometimes associated with MS include sudden hearing loss and ringing in the ears, also known as tinnitus. These hearing problems sometimes develop due to MS-related nerve damage, but are uncommon symptoms of MS.

Hearing problems are very common among adults. Approximately 14% of US adults aged 20 to 69 years have hearing loss, according to a study published in 2017 in JAMA Otolaryngology Head and Neck Surgery. Given how prevalent hearing problems are overall, any new hearing-related symptom needs to be thoroughly evaluated to rule out non-MS-related causes, such as an accumulation of ear wax, noise- or medication-related hearing loss, and inner ear disease, among others. 

That said, MS is sometimes responsible for hearing problems—but this is relatively rare. A study involving 2,736 people with MS found that only 0.7% experienced sudden hearing loss over an 11-year period, as reported in 2016 in the Multiple Sclerosis Journal—Experimental, Translational and Clinical. Ringing in the ears is even less commonly associated with MS.

Most Common MS-Related Hearing Problems

Sudden hearing loss and ringing in the ears are the most common MS-related hearing problems.

Sudden Hearing Loss

By definition, sudden hearing loss develops quickly. The impairment can happen all at once or over a few days. Some people report a popping sound before the hearing loss. This dramatic, rapid onset differentiates sudden hearing loss from age- and noise-related hearing loss, which develop gradually.

As in people without MS, the development of sudden hearing loss associated with multiple sclerosis tends to occur unilaterally, meaning it affects only one ear. However, there are rare cases when both ears are affected, or the hearing loss affects one ear followed by the other.

Sudden hearing loss does not necessarily mean that you are completely deaf in the affected ear. From a medical perspective, this condition is defined as the rapid loss of at least 30 decibels. Decibels are a measure of sound intensity. Loss of 30 decibels is akin to perceiving normal conversation as if it were being whispered.

The researchers who conducted the 2016 Multiple Sclerosis Journal—Experimental, Translational and Clinical study noted that when MS-related sudden hearing loss develops, it is usually several years after initial diagnosis. Hearing loss is very rarely an initial symptom of MS. 

Tinnitus

Many people think of tinnitus as ringing in the ears, but it can also sound like a whistle, click, murmur, or a whooshing noise. It can be loud enough to interfere with your hearing or a soft noise you only notice when in quiet surroundings. Tinnitus alone is very rarely due to MS. However, about half of people who develop sudden hearing loss also experience tinnitus.

A third symptom called vertigo might also accompany MS-related hearing loss and tinnitus. Vertigo refers to the sensation that the world around you is spinning. Most people have experienced this sensation at least once in their lifetime, either as a child after twirling around a few too many times, or perhaps after a night of drinking too much alcohol.

Cause of MS-Related Hearing Problems

Sudden hearing loss—without or without ringing in the ears or another form of tinnitus—may signal an MS relapse. Like other MS-related symptoms, these problems occur due to nerve damage in the brain. An MS lesion located in any of several areas of the brain involved in hearing or involvement of the eighth cranial nerve, which carries nerve signals to and from the inner ear, can potentially cause hearing loss, with or without tinnitus.

Treatment and Recovery

Sudden hearing loss and related tinnitus caused by MS usually resolves with a short course of corticosteroid therapy, such as Medrol (methylprednisolone). Most people experience complete recovery over several weeks to months. However, some people experience only partial recovery of their hearing, and a small percentage of people are left with permanent hearing loss. 

A Word From Verywell

When you're living with multiple sclerosis, it's often very challenging to determine whether a new symptom is or is not related to your MS. If you experience sudden hearing loss and/or ringing in the ears or another form of tinnitus, contact your doctor without delay. Your neurologist might suggest that you see an ear, nose and throat specialist first to check for non-MS-related causes.

If non-MS-related causes are ruled out, your neurologist might recommend a brain MRI and/or an auditory brainstem response test, which assesses the transmission of electrical signals from your inners ears to other areas of your brain involved in hearing. Treatment will depend on whether your MS or another problem is found to be the culprit for your symptoms.

Sources:

Atula S, Sinkkonen S, Saat R, Sairanen T, Atula T. Association of Multiple Sclerosis and Sudden Sensorineural Hearing Loss. Mult Scler J Exp Transl Clin. 2016;2:2055217316652155. doi:10.1177/2055217316652155.

Hellmann MA, Steiner I,Mosberg-Galili R. Sudden Sensorineural Hearing Loss in Multiple Sclerosis: Clinical Course and Possible Pathogenesis. Acta Neurol Scand. 2011 Oct;124(4):245-9.

Hoffman HJ, Dobie RA, Losonczy KG, Themann CL, Flamme GA. Declining Prevalence of Hearing Loss in US Adults Aged 20 to 69 Years. JAMA Otolaryngol Head Neck Surg. 2017 Mar 1;(143)3:274-285.

Sudden Deafness. Massachusetts Eye and Ear Website. http://www.masseyeandear.org/for-patients/patient-guide/patient-education/diseases-and-conditions/sudden-deafness

Sudden Deafness. National Institute on Deafness and Other Communication Disorders website. https://www.nidcd.nih.gov/health/sudden-deafness

Wolfson AB, Hendey GW, Ling LJ, et al., eds. Harwood-Nuss' Clinical Practice of Emergency Medicine. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009.

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