Hearing Loss and MS?

[Udkas]

Hi Everyone,

As most of you know I am not diagnosed with MS but Transverse Myelitis but my first neurologist did diagnose me with MS and then said probable and then thought perhaps a CIS.

Anyway back when I had what I thought was my big "MS Attack", many years ago I also suffered hearing loss around the same time in my right ear, which is permanent, I did complain to the neuro at the time that I had the feeling often of being in an aeroplane with sudden loss of hearing.  I also  had numbness in my face and Trigminial neuralgia (sorry if I have spelt that wrong.

When I had what I thought was another attack a few years ago I also had some facial numbness that my current doctor put down to migraine, but does say I have spinal lesions, my brain MRI is perfect but I have noticed that my hearing loss in my right ear is so bad that if I have that ear facing up and my good ear laying on the pillow when in bed I cannot even hear the clock radio in the morning, so I am in danger of sleeping in and if my husband tries to talk to me it is just a muffle, I think I am almost totally deaf in that ear.  I am 44 years old.  I have not worked in an industry that would cause damage to my ears.  I don't have wax or anything like that in them.

I have decided I should at least get my hearing checked out but is it worth mentioning this to the neurologist, or even to the audiologist, is there way that they can tell if it is related to nerve damage from MS? Can audiologists tell what has caused the hearing loss.

QUESTIONS so they don't get lost in this post.

Can MS cause hearing loss?

Can an audiologist tell if it is from nerve damage?

Where would the lesion be if you have hearing loss and is it easily detectable on MRI?

Should I just go and get my hearing checked or should i chat to my neurologist about the possibilities?

Thanks guys,
Cheers,
Udkas.

[Nancy T]

Unbelievable that you have never had either an ENT or a neuro evaluate your hearing loss. Your GP was extremely negligent in not following up on that.

Normally in this country one sees an ENT first, who usually have audiologists on staff, so if a hearing loss is discovered you are already under the care of an ENT and will get the medical investigation. That's how it happened with me, anyway.

GPs can be notoriously cavalier about hearing loss. I will never understand that attitude. (I'll spare you more of my story on that point; you've probably heard it anyway.)

If you cannot understand speech on the phone, you are definitely in trouble with that ear.

Hopefully the ENT's brains will match his looks. :) Please let us know what happens!

Nancy

[Udkas]

Thanks again for your info I am finding all this very interesting.  The silly thing is years ago when I went and had my hearing tested the audiologist sent a letter to my GP stating that I needed further investigation because to have such hearing loss at 34 years old in one ear is not normal, my GP told me he received the letter but failed to do anything about it.  

This time he will have to refer as the audiologist told me already that she will be recommending it as with such hearing loss in one ear it needs to be investigated.

I do have my own mute button and I am lucky as people could be holding a raging party next door and if i put my bad ear up and sleep with my good ear to the pillow I never hear a thing.  My neuro is not aware of my hearing loss, but is aware of my vertigo.  My last real bout of vertigo was when I thought I was having another attack?  My neuro still seems to think my facial stuff and vertigo is migraine and i must admit I often get headaches with the vertigo.  

I am sure I am worse but maybe I am not but a fresh look won't hurt.  Although my neuro has said that I have lesions in thoracic and cervical he did mention the brainstem on more than one occasion and apparently that is not as easy to image. So maybe something might show up in there finer slices.  

If I swap ears on those telephone recorded messages when you are on hold I cannot distinguish any of the words they are saying with my bad ear.  Oh and there is another bonus the ENT specialist is a hotty, so I can have some eye candy during my visit...lol. He fixed my son's broken nose and is very, very nice., I best not tell my hubby this..lol

Cheers,
Udkas.

[Nancy T]

Hi Udkas. Be sure to mention the vertigo when you see the audiologist and ENT. But don't rely only on the words "vertigo" or "dizziness" when talking to them; be sure to describe your symptoms, what happens exactly, when, what makes it better or worse. Even if you aren't currently having dizziness/vertigo, tell them about your history of it.

I am very surprised that with your history of hearing problems you've never seen an ENT or had an MRI to rule out acoustic neuroma. If you are only hearing muffled sounds with your good ear down, you must have a really significant hearing loss. (The good thing about being deaf on one side is, when you want to sleep and there's noise, you just flop over on your good-ear side and voila, the mute button! :)

Actually I might have been a bit misleading in my previous post--although an acoustic neuroma is the only EAR problem that I think they can distinguish on MRI (and getting a thin-slice MRI with contrast focused on the inner ear will indeed rule that out), they may be able to see brainstem lesions that could cause hearing loss. I don't think this is too common; even if they don't see any lesions, your hearing loss is proof enough that something is wrong. The configuration of the hearing loss and the auditory evoked potentials (if they do them) should give them valuable information.

It's very good that you're getting your old test results for comparison purposes.

I too had my hearing loss at the time that a whole raft of other symptoms occurred. However, my loss was more likely a structural thing such as a blood-vessel blockage, because it occurred when I sneezed. And my hearing has never fluctuated since that moment, as far as I can tell. My audiograms over the years have varied only a little, probably because of the nature of the testing (and how good I've gotten at guessing!--they always say "airplane, baseball, cowboy..."). My speech discrimination has improved somewhat, but again I think that's due to better guessing and better testing methods. I really cannot hear any better in that ear than since the moment I sneezed 11 years ago. Luckily I was finally able to get a Baha (bone-anchored hearing aid) two years ago, which is great for people with one very bad ear and one very good ear. You might have some hearing-aid options--be sure to ask the audiologist.

Good luck to you! :)

[Udkas]

Thank you both for your information, In my own mind I still suspect that I have a lesion that is is either so small or is just being missed in the MRI process ( I don't know) but my hearing was affected years ago, suddenly when I had all my other symptoms going on at the time.  Prior to that I had no hearing loss.  

I feel my hearing fluctuates like my other symptoms but I do believe it has got worse, but I do have the results from my testing 10 years ago being sent out to me and should have them tomorrow to take to my new appointment next week which will at least let them know if I have indeed suffered more hearing loss.  My family have been complaining for ages to get my hearing checked.. I have never been seen by a ENT specialist before and my last brain MRI was 2 or 3 years ago now..

The Audiologist told me the same as you guys have said that one sided hearing loss is normally from a medical condition and should be checked and that they would probably want to do an MRI. I find it interesting Sarah that you were diagnosed from your hearing problems as although MS can affect your hearing it is not very common from what I understand.  Is that lesion in your brainstem???

Nancy you seem to have a good understanding of all this, thanks for explaining the testing, it should be interesting, I do get some vertigo as well but I have not had any for quite a while.  I will post my outcomes when I have the tests done. My appt. with the audiologist in on Thur.

Cheers,
Udkas.

[Sparkysarah]

Hi

I was recenlty diagnosed with RRMS but my diagnosis came about as a result of my hearing loss and numbness of one side of face. To cut a long story short I had my ears syringed in case it was ear wax but still could not hear properly on one side. Was then sent to ENT Consultant and Audiologist and hearing test came back nearly normal but slight loss on high frequency sounds on one side. So then sent for MRI to check fo acoustic neuroma and luckily they did not find on..but they found several lesions instead and the rest is history. I was then referred to Neurologist, more MRI scans and dx of MS came quickly. My new Consultant said that I have one lesion which will affect my hearing but there is not much they can do for it..so I am just putting up with it but if it continues I can ask to go back to ENT Consultant so will wait and see.

Good luck with all your tests and I hope you get to the bottom of it.

Cheers for now

Sarah

[Nancy T]

Hi Udkas. Audiologists and ENTs can tell some things with an evaluation of your hearing and usually figure out whether it's a problem with the ear itself (the inner ear) or a "retrocochlear" problem, in other words a problem with the hearing nerve and/or its connections with the brainstem.

For people with one-sided hearing loss they will want to do an MRI looking specifically at the inner ear/hearing nerve to see whether you have an acoustic neuroma (benign tumor of the hearing nerve). This should be done with contrast (an injection given in the middle of the MRI, to show small tumors).

The hearing professionals seem to think that  once you've had an MRI, there's no reason to do auditory evoked potentials (which are sometimes done if there's a suspicion of acoustic neuroma, and if the AEP is abnormal they  move on to MRI, but now they usually just go straight to the MRI).

Yet my dizziness/hearing-specialist neurologist ordered AEPs (aka ABR) AFTER I'd had a normal MRI looking for acoustic neuroma (after my sudden one-sided hearing loss). And lo and behold, my ABR was very abnormal, on both sides, not just the hearing-loss side. He called it "cranial neuropathy."

Also, one of the tests the audiologists may do is acoustic reflex testing, which can also find a "retrocochlear" problem. I had abnormal acoustic reflex decay. That stuff is a bit complicated.

If your MRI is normal, or doesn't show a problem with the ear (and the only ear problems it can show, AFAIK, is an acoustic neuroma--other problems won't show up), I would try to get ABR done anyway--it might be a piece of evidence in diagnosis, even though the ABR is nonspecific. My abnormal ABR didn't get me anywhere with a diagnosis--all it did was show that SOMETHING was wrong.

It's very good you're getting an evaluation by an audiologist and ENT. Be sure to let us know the results.

Nancy

[Udkas]

Hi Guys,
Thank you for your speedy replies.  I have now organised to see a hearing clinic who is also affiliated with the ear, nose and throat specialists.  They can refer me to the ENT Specialist.

From the info I received from the audiologist they can tell if it is coming from the brainstem or spinal cord etc., she said that often now they just recommend an MRI rather than using the audio evoked potentials, but when they are looking for ear problems the protocol is different from my normal MRI, so the slices are different, so I might still have a lesion that is affecting my hearing.

Apparently hearing loss in one ear is rare and is usually from a medical problem and could be as simple as having fluid in my ear but I should have it evaluated because it could indeed be a preventable problem that might get worse or it might be something I just have to live with, anyway my appointment is next week and I imagine that my appointment with the ear/nose and throat specialist will be much later down the track.

I will discuss with them my bouts of vertigo too.

Will keep you all posted, but yes you are right there is a very real  possabliity that this hearing loss is from a lesion.

Cheers,
Udkas.

They can conduct auditory evoked potentials tests, but these tests are usually only done if the ENT specialists recommends it.

[Ufrustrated2]

>>but is it worth mentioning this to the neurologist, or even to the audiologist,

    certainly. my VA neuro hasn't listened much to me about my hearing issues, but the
audiologist did. don't forget that is a VA neuro


>>Can MS cause hearing loss?

    yes, according to a list of MS symptoms on some MS websites


>>Can an audiologist tell if it is from nerve damage?

not qualified to answer a yes or no, but i suspect they can rule out actual ear damage and then take into consideration neurological deficits


case in point, the VA audiologist who lists me with severe hearing loss and equilibirum issues has told me mine is more a neurological problem due to not a signifcant amount of ear damage. there is some actual ear drum scarring due to other external things from the past but not enough to cause the degree of hearing loss/understanding i have  -- so she says

hope that helps some ...

[ashleyPT]

MS can cause hearing issues and they have an auditory evoked potential test to help diagnose the origin.  I really don't know much about this though, so I'm sure someone else will have more answers.