Hearing Problems and Multiple Sclerosis
Hearing problems are not a common symptom of multiple sclerosis. That’s good news. However, for approximately 4 to 6 percent of individuals with MS, hearing challenges are a reality that can have an impact on their quality of life, although the other good news is that most patients recover completely.
Hearing problems associated with multiple sclerosis can include tinnitus (ringing in the ears) and varying degrees of hearing deficit or loss, which is defined as a loss of 30 decibels or more. This amount of hearing deficit is about half as loud as normal talking. Another hearing-related problem that can be experienced by people with multiple sclerosis is receptive aphasia.
Tinnitus, which is not a common occurrence in MS, can include more than ringing; murmurs, clicks, buzzing, and whistling sounds are also common. Among people with MS who experience tinnitus, the symptoms typically go away completely within a short time and do not cause any hearing deficits.
Hearing loss related to MS usually occurs suddenly or over just a few days, a characteristic that distinguishes it from age-related hearing loss, which develops gradually. In the vast majority of cases, the hearing loss occurs in one ear only.
In one study, investigators reviewed the files from a five-year period of patients with multiple sclerosis. Of 253 patients, 11 (4.35%) had experienced sudden hearing loss. Of these, seven had hearing loss as their presenting symptom of MS.
Hearing loss developed early in the disease in all 11 patients, and it occurred in one ear only in all cases. Nine of the 11 patients had no residual hearing deficit.
Receptive aphasia is an infrequent challenge in MS. Individuals with receptive aphasia can hear voices but may not understand what is being said. As a result, their own speech may be affected because they do not understand their own words.
Things to know about hearing loss and multiple sclerosis
Here are a few points to consider about hearing problems and multiple sclerosis:
- Hearing loss may occur during an acute exacerbation of the disease
- Sudden hearing loss can signal an MS relapse
- Hearing loss can be related to heat exposure
- On very rare occasions, hearing loss can be the first symptom of the disease
- The majority of acute episodes of hearing deficit associated with MS improve
- Complete hearing loss (deafness) associated with MS is very rare
Causes of hearing loss in MS
Experts have several theories about hearing deficits caused by multiple sclerosis. One is that inflammation and/or scarring around the auditory nerve (the eighth cranial nerve) is the culprit. Another possible cause is the accumulation of plaque on damaged nerves along the auditory pathways.
What to do about hearing problems
It is entirely possible that any hearing problems you may experience are not related to MS, so it’s important to consider those factors first. These can include presence of excessive ear wax, Meniere’s disease, ear infection, exposure to loud noise, injury, or ototoxic medications (drugs that can harm the ears). This last category includes loop diuretics, aminoglycoside antibiotics, salicylates, and chemotherapy drugs, among others.
Note, however, that use of intramuscular interferon beta-1a (Avonex) has been associated with decreased hearing sensitivity. If you are taking this drug, you should be aware of this possible side effect.
Any problems with your hearing should be reported to your neurologist. If your doctor dismisses your concerns, you can see an otolaryngologist (ear, nose and throat specialist) to rule out other causes. You also can talk with an audiologist; the American Academy of Audiology has a website that can help you locate certified professionals.
Hellmann MA et al. Sudden sensorineural hearing loss in multiple sclerosis: clinical course and possible pathogenesis. Acta Neurologica Scandinavica 2011 Oct; 124(4): 245-49
Lewis MS et al. Does interferon beta-1a impact pure-tone hearing sensitivity among individuals with multiple sclerosis? Journal of Neuroscience Nursing 2014 Dec; 46(6): 351-60