Multiple sclerosis (MS) is a progressive condition affecting the central nervous system (CNS). It can result in a wide range of symptoms throughout the body. In some cases, MS may cause hearing problems or other issues relating to the function of the ears.

MS is a chronic condition affecting the CNS. Evidence suggests that it is an autoimmune disorder, meaning the immune system mistakenly attacks healthy tissue. In the case of MS, the immune system attacks the protective linings of the nerves, called myelin. The results can disrupt how the brain sends signals to the body.

The course of MS is unpredictable and can cause a variety of symptoms in different people. It may cause hearing problems and other symptoms that have to do with the function of the inner ear, such as hearing loss, tinnitus, balance problems, and a muffled or full feeling in the ear.

In this article, we will discuss hearing complications associated with MS, treatment options, and when a person should see a doctor.

A person with MS experiencing difficulty with their hearing.Share on Pinterest
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MS is not completely predictable. The course of the disease can vary greatly from one person to the next and can lead to a wide range of symptoms in different people. MS affecting different areas of the CNS may result in the specific symptoms in each case.

Hearing problems are an uncommon but possible complication of MS, occurring in roughly 6% of people with MS. They may result from damage to the hearing nerve pathways present in the brain and brainstem.

Hearing difficulties may occur as part of an exacerbation of the condition. This refers to when old symptoms get worse or new ones develop. Hearing problems can be a short-term symptom in some cases, but some people may experience longer lasting changes to their hearing.

While it is possible for MS to cause hearing problems, there are other more common causes such as aging, exposure to loud noises, excessive earwax, damage to the eardrum, and ear infections.

Sensorineural hearing loss (SNHL) is a type of hearing loss that can occur after damage to the nerve pathways of the inner ear. While hearing loss is not a common symptom of MS, evidence notes that SNHL in the MS population far exceeds that in the general population.

It can make softer sounds hard to hear and may cause louder sounds to be unclear or sound muffled. This may make it difficult for a person to understand words against background noises.

SNHL may follow a progressive or fluctuating pattern in people with MS. A 2018 systematic review notes that it is more common in the early stages of the disease and may come on suddenly. But it may also occur progressively as the disease itself progresses.

Sudden sensorineural hearing loss is a rapid impairment of hearing. A person may lose a noticeable amount of hearing all at once or over a few days. Medically, this includes a loss of 30 decibels or more of hearing capabilities. For comparison, this would make whispers very hard to hear, or inaudible, and make normal conversations sound about the same as whispers.

This type of hearing loss does not often have an identifiable cause, but typically occurs due to an underlying condition that damages the nerves or sensory organs of the inner ear.

A 2016 study notes that sudden hearing loss is rare in MS, occurring in 3% of cases at most. Sudden hearing loss may appear both in the early stages of the disease or in later stages as the disease progresses. In some rare cases, it may be the first symptom a person experiences.

Research suggests that sudden hearing loss in MS is commonly unilateral, meaning it occurs in one ear rather than both. A 2021 review adds that sudden hearing loss in one ear is also the most common presenting symptom involving the ear in MS. But in some cases it may occur in both ears. Hearing loss may also begin in one ear and then later affect the other ear.

Tinnitus is a relatively common symptom with a number of potential causes. Aging ears, exposure to loud sounds, or certain conditions can result in tinnitus.

Tinnitus may sound like ringing in the ears, but this is not the only sound that can occur. Some may describe the sound of tinnitus as:

  • buzzing
  • whistling
  • hissing
  • whooshing
  • humming
  • clicking
  • murmuring or mumbling

Evidence suggests that tinnitus occurs in about 1% of MS cases. Tinnitus due to MS may occur due to damage of the nerves controlling the ear.

Damage to the nerves in the area may lead to a few other hearing-related issues in a person with MS. Some hearing problems that can occur due to MS may involve:

  • distortions or changes in sounds
  • difficulty hearing and understanding speech
  • increased sensitivity to sounds

If sudden hearing symptoms occur in someone with known MS, a doctor may prescribe and administer corticosteroids. The National Institute on Deafness and Other Communication Disorders notes that a doctor may administer steroids as soon as possible and may suggest them before test results return confirming a diagnosis.

Quickly administering corticosteroids may be effective at controlling damage and increasing the likelihood of recovering hearing. Delaying treatment will likely decrease the effectiveness of treatments.

Research indicates that roughly 64% of people receiving corticosteroid treatment experienced a complete hearing recovery after sudden hearing loss due to MS. Still, some may not experience a complete recovery of symptoms. About 14% of people experienced no recovery of hearing. Remission times can vary as well, and may occur in 1 week to 5 months.

Sometimes additional treatments may be necessary to manage permanent hearing loss. This may include devices such as cochlear implants or hearing aids to amplify sounds or stimulate hearing in the brain.

Currently, there are no effective home treatments for hearing disorders. Instead, a person should see a doctor as soon as possible to help diagnose and treat the underlying issue to get the best chance at recovery.

People can support the efforts of treatment by avoiding further damage to the ears. This may include avoiding sticking anything in the ear, such as cotton swabs, toothpicks, or fingers, listening to loud music or television, wearing loud headphones, or operating heavy machinery without hearing guards.

Anyone who is worried about symptoms relating to their hearing, such as any difficulties, ringing, or ear fullness, should see their doctor for a full diagnosis.

Additionally, if a person does not have a diagnosis of MS but begins to notice early signs, it is advisable that they see their doctor. While this may vary in each case, some early signs of MS can include:

  • difficulties with balance
  • speech difficulties
  • numbness and tingling
  • blurry vision
  • pain and muscle spasms
  • sensitivity to heat, such as feeling faint or dizzy in hot temperatures
  • general fatigue
  • pain
  • urinary or bowel issues
  • sexual dysfunction
  • difficulty swallowing
  • cognitive difficulties
  • changes in mood

Anyone with known MS who experiences hearing issues should also see their doctor as soon as possible, as it may be a sign of exacerbation. The earlier doctors can diagnose conditions and their underlying causes, the quicker they can issue treatments.

While hearing complications are rare, it is possible for MS to cause hearing impairments. This is likely due to the immune system damaging the hearing nerve pathways present in the brain and brainstem.

In some cases, hearing loss or difficulties can be a sign of an MS exacerbation. In others, hearing loss may be their first sign of MS. Hearing loss from MS may not be permanent depending on the type, and many people may make a full recovery. It is important to receive a quick diagnosis and treatment from a doctor to ensure the best chance at a full recovery.