About 6 percent of people living with multiple sclerosis experience hearing loss. Although acute hearing impairment caused by MS tends to improve, it’s important to let your health care provider know as soon as you notice any changes in your hearing. They will be able to evaluate your symptoms and rule out any other potential causes of hearing loss.
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS), which includes the brain and spinal cord. In people with MS, the body’s defenders (white blood cells) attack the central nervous system, causing inflammation and stripping the protective coating that normally covers the nerves (myelin), leaving them vulnerable and reducing their ability to transmit electrical signals. Over time, this process (called demyelination) can cause people with MS to experience a variety of symptoms that affect physical movement, eyesight, and cognitive (mental) functioning.
Hearing loss in MS is rare, affecting only about 6 percent of people with the condition. Even more rarely, hearing loss may be the first symptom of multiple sclerosis. Hearing loss may affect people with early or long-standing MS.
It is believed that MS-related hearing loss can result from damage to the nerve pathways in the brain and brain stem. Multiple sclerosis causes lesions, or areas of damage and scarring (sclerosis), to form along the central nervous system. MS lesions on the brain stem, auditory (cochlear) nerve, or other sites can disrupt the auditory pathway, potentially leading to hearing loss.
Sensorineural hearing loss refers to hearing loss caused by damage to the auditory nerve or the structures of the inner ear. Although it is not a common MS symptom, this type of hearing loss is far more common in people with multiple sclerosis than in the general population. Sudden sensorineural hearing loss (SSHL), in particular, develops over several hours to three days. In 4 percent to 10 percent of people with MS, this type of hearing loss occurs between relapses (flare-ups) or remissions (symptom-free periods). As one MyMSTeam member wrote about their hearing loss, “I've experienced it since my flare-up last March.”
MyMSTeam members have reported hearing loss alongside their other MS symptoms. One explained that their hearing loss was gradual: “I have been slowly losing my hearing over the past week. It’s a little annoying. I can hear a little bit, but not much.” Another similarly noted that the hearing in their right ear had been slowly declining since being diagnosed with relapsing-remitting multiple sclerosis.
One member, however, shared that abrupt hearing loss was what drove them to see their doctor: “I woke up one day and couldn’t hear out of one side. It was the final straw that caused my husband to insist on the MRI that resulted in my diagnosis.”
No matter whether you experience gradual auditory abnormalities or a sudden loss of hearing, you should talk to an audiology or neurology expert as soon as you notice any changes in your ability to hear.
It is important to note that MS may not necessarily be the cause of hearing loss. As one MyMSTeam member shared, “About three years ago, my hearing in my right ear was very muffled, and I had a lot of ringing. I was sent for hearing tests and an MRI, and it wasn’t to do with the MS — I was diagnosed with Ménière’s disease.” It is important to see a health care professional for diagnosis as soon as you notice any changes in your hearing to rule out the possibility of another condition.
In most cases, an audiologist — a health care provider specializing in the evaluation, diagnosis, and treatment of hearing problems and balance disorders — will be the one to make this determination. They will be able to determine whether MS or another condition or illness, such as an ear infection, may be causing changes in your hearing.
Two types of tests may be used to diagnose hearing loss in people with MS: an auditory brain stem response (ABR) test or magnetic resonance imaging (MRI).
An auditory brain stem response (ABR) test (sometimes called BAER) determines how well the inner ear (cochlea) and the brain’s auditory pathways are functioning. This screening test is used to diagnose hearing loss in people whose symptoms may be caused by changes in the brain or a brain pathway. It is the most appropriate test to diagnose sensorineural hearing loss in people with MS.
During an ABR test, adhesive electrodes are stuck to the skin on your scalp and connected to a computer. These electrodes record changes in brain wave activity that occur in response to sounds being played through a pair of earphones.
Hearing loss may be unilateral (one-sided) or bilateral (affecting both ears). If you have unilateral hearing loss and are believed to have sensorineural hearing loss, a neurologist may recommend undergoing MRI. This imaging test uses radio waves and magnetic fields to create detailed images of the inner ear and its surrounding structures, which can reveal MS lesions on the auditory nerve pathway.
MS-related hearing loss is commonly managed with hearing aids or medication.
Several MyMSTeam members have reported using hearing aids. One member shared that their audiologist recommended hearing aids despite having only minor hearing loss: “Yesterday, I found out I have some hearing loss! The audiologist told the doctor I would benefit from wearing hearing aids, even though my hearing loss is mild right now,” they said.
Another member with mild hearing loss wrote that hearing aids had a unique benefit: improving concentration. “I have mild hearing loss due to my MS,” wrote this member. “I tried out some hearing aids, and I really like the way they help me focus.”
One MyMSTeam member wrote that Solu-Medrol resolved their gradual hearing loss: “The hearing loss was a part of the laundry list of issues that I had been dealing with for about a month. … After the five days of Solu-Medrol, my hearing returned.” However, another member found that this medication treated everything but their hearing loss: “I treated my hearing loss as allergy/sinus issues for several months until I started digging more into MS-hearing loss links. It made sense since it started during my flare-up, but that was one of the only things the intravenous methylprednisolone didn’t help.”
Ultimately, you and your doctor can work together to find the best treatment for MS-related hearing loss.
MyMSTeam is the social network for people living with MS and their loved ones. Here, more than 165,000 members come together to ask and answer questions, offer support, and share their experiences with multiple sclerosis.
Have you developed MS-related hearing loss? Share your story in the comments below or by making a post on MyMSTeam.