Not all symptoms of multiple sclerosis are common, but that doesn’t mean a patient won’t experience those symptoms. Every case of the disease is different, and then list of symptoms can vary significantly from one patient to another, especially depending on health at the time of onset, when the disease is diagnosed, and even differences in environment.
One of the less common symptoms of multiple sclerosis is hearing loss. While hearing loss is common among all of society, with something like one in five individuals having some form of hearing loss, as a symptom related to MS, it’s far less common. However, it can have a serious impact on the life of a patient with MS, so it’s important to know these five things about hearing loss that comes with the disease.
1. How hearing loss occurs in MS
Like other symptoms of multiple sclerosis, hearing loss is based on nerve damaged caused by an attack on the central nervous system (CNS). In multiple sclerosis, the body’s immune system attacks and destroys the protective sheath of myelin covering the nerves, which damages this substance, resulting in interference with the brain and spinal cord’s communication with the nerves in the rest of the body. This can cause those peripheral nerves, as well, to deteriorate, with the nerve damage irreversible. Hearing loss is possible if the nerves that control hearing and other auditory functions are damaged or deteriorate.
2. Types of hearing problems that may occur in MS
Hearing loss is the least common of hearing ailments associated with multiple sclerosis. In fact, less than one percent of MS patients experience hearing loss over the course of the disease. When hearing loss occurs, it’s usually only in one ear, making it easier to define this as a symptom of MS. However, there are other things that can happen with nerve damage related to hearing that could be of concern.
- Tinnitus – This is defined as a constant ringing or buzzing in the ears that is not related to outside noise. While it never goes away, it’s usually more pronounced at night due to a lack of background noise to drown out the sound.
- Discernment – In some cases, rather than experiencing true hearing loss, MS patients find it difficult to discern and understand speech when there is a great deal of background noise. This is a problem with communication as well as with such things as trying to watch a movie with a loud soundtrack or even listening to the news or other television program while performing other tasks that involve noise.
- Hyperacusis – Some patients have extreme sensitivity to noise, which is known as hyperacusis. This condition can be mild, where the sounds are simply a bit distracting, or it can be extreme, with patients experiencing difficulty thinking due to excess noise or even developing headache and migraine because of the hypersensitivity.
- Sudden hearing loss – When patients with multiple sclerosis do experience true hearing loss, it’s rarely a buildup over time. Typically, it’s a sudden hearing loss. The technical definition of “sudden” is that the patient loses at least thirty decibels over the course of no more than seventy-two hours (three days). For comparison, normal conversation is usually at a volume of about sixty decibels.
Because people with multiple sclerosis are extremely sensitive to heat, this may actually cause sudden hearing loss or other issues, as opposed to it being a direct symptom of nerve damage. This can be determined if cooling off remedies the issue.
3. Multiple sclerosis and related issues
It’s thought that damage to the brain stem leads to hearing loss and other hearing issues in multiple sclerosis. Therefore, when hearing loss is experienced, there are usually a complete other subset of symptoms that occur, based on the fact that these functions are also controlled by the brain stem and would be affected by such damage.
- Problems with vision – this could be blurred vision, double vision, eye pain (especially when moving the eyes), difficulty controlling eye movement, and vision loss
- Balance – the brain stem also controls the ability to balance and can lead to difficulty maintaining balance, dizziness, and vertigo (the sensation of spinning or being in a room that is spinning)
4. Prevalence of hearing loss in MS
While relatively few MS patients experience sudden hearing loss as a symptom of the disease, combine with other hearing issues, it’s common enough for patients to have at least one episode of hearing troubles as the disease progresses. In some patients, this is one of the symptoms that leads to diagnosis of the disease in the first place, while others don’t experience any impairment in hearing until they are advanced, years into the progression of the disease.
Overall, it’s estimated that hearing impairment affects between one and five patients out of a hundred.
5. Treatment for hearing loss in MS
Before treating it as a symptom of MS, hearing loss and impairment should be tested, with other causes first ruled out. It is far more likely that they are the result of some other condition, based on statistics. Having excessive ear wax, taking certain medications, some illnesses, exposure to loud noises, and injury are all causes that should first be ruled out.
Not much can be done for true hearing loss. The good news is that, when associated with multiple sclerosis, the symptoms come and go with relapses. In fact, sudden hearing loss and appearance of tinnitus are often signs of an impending relapse. If the symptoms persist, steroids may be prescribed to lessen any inflammation that exacerbates the symptoms.
While it’s not the most common symptom of the disease, multiple sclerosis related hearing loss and other hearing impairments can be shocking and debilitating, especially if they compound and there isn’t a recovery after a relapse. Taking the steps to rule out other causes can make it easier to determine if the problem is related to multiple sclerosis, at which point determining the best course of treatment – typically with corticosteroids – or non-treatment is best for each specific patient and their circumstances.