Association of multiple sclerosis and sudden sensorineural hearing loss

Abstract

BackgroundMultiple sclerosis (MS) may affect other cranial nerves besides the optic nerve. Sudden sensorineural hearing loss (SSHL), possibly caused by a deficit in the auditory tract, including the vestibulocochlear nerve, is sometimes associated with MS.ObjectivesWe aimed to assess the incidence of SSHL among MS patients, its frequency as an initial symptom of MS, and magnetic resonance imaging (MRI) findings associated with SSHL in MS.MethodsWe collected retrospectively all patients diagnosed with MS and SSHL at the Helsinki University Hospital between 2004 and 2014. Patients with both diagnoses were re-evaluated using hospital medical records, audiograms and head MRI scans.ResultsA total of 2736 patients were diagnosed with MS, 1581 patients with SSHL, and 18 patients (0.7% of all MS patients) with both; two patients presented with SSHL as an initial symptom of MS. The annual incidence of SSHL was 59.8/100 000 (95% confidence interval (CI) 37.7–94.9) in MS patients, and 12.4/100 000 (95% CI 11.8–13.0) in the normal population.ConclusionSSHL is a rare symptom of MS and is even less frequent as an initial symptom. Its incidence in MS patients, however, markedly exceeds that in the normal population.

Trigeminal neuralgia in multiple sclerosis: Prevalence and association with demyelination

“…Optic neuritis (ON) is by far the most common cranial nerve symptom in MS, with a prevalence of almost 50% during the course of the disease. The reason for an increased incidence of ON in MS has been speculated to be connected with the histological features of cranial nerves 2 . Myelin sheath encircling the optic nerve is produced by oligodendroglial cells, whereas in other cranial nerves from the third nerve onwards the myelin is mainly produced by Schwann cells.…”

“…Disease course is relapsing remitting (RRMS) in approximately 85% of patients, where a new demyelinating lesion or lesions may cause a new symptomatic period. Demyelinating lesions of the brain stem can present with symptoms of the cranial nerves, such as sudden sensorineural hearing loss, 2 abnormal eye movements 3 or facial motor paresis, 4 in addition to painful trigeminal neuralgia (TN).…”

Otolaryngologic Symptoms in Multiple Sclerosis: A Review

“…Several studies have documented the relationship between MS and hearing loss and tinnitus [16][17][18][19][20] . Hearing deficits in MS present in the form of sudden, progressive or fluctuating SNHL they may appear in the early stages of the disease, often as presenting symptoms, or during the late stages indicating a disease progression as a result of a progressive involvement of the hearing pathways 17,19,20 .…”

“…Sudden SNHL is more common in the early stages (within two years from diagnosis), while progressive SNHL in late stages (after five years) [16][17][18][19][20] or derive from central nervous system demyelination, especially in cases in which no auditory alterations are evident 18,40 .…”

Management of sudden sensorineural hearing loss among primary care physicians in Canada: A survey study

“…SSNHL can also be a consequence of impaired blood flow to the cochlea resulting from acute vascular hemorrhage [ 12 , 13 ], embolic occlusion [ 14 ], vascular disease [ 15 ], vasospasm [ 16 ] or hyperviscosity [ 17 , 18 ]. Several autoimmune disorders, including Cogan’s Syndrome [ 19 , 20 ], multiple sclerosis [ 21 , 22 ], rheumatoid arthritis [ 23 ], systemic lupus erythematosus [ 24 , 25 ] and Behçet Syndrome [ 26 , 27 ] can give rise to SSNHL. Sudden hearing loss is also characteristic of Meniere’s disease [ 2 , 28 – 30 ], and vestibular schwannoma [ 31 – 35 ].…”