Effects of Multiple Sclerosis on the Audio-Vestibular System (PP-03)

Objective: Multiple sclerosis (MS) is a demyelinating disease of the nervous system that affects the brain and spinal cord. As well, Brainstem involvement is common in MS. So, MS may impact the audio-vestibular pathway at different stages of the disease. The aim of this study is to investigate the effects of MS on the audio-vestibular system.
Method and materials: We performed a literature review with the following keywords: Audio-Vestibular system, Evoked potentials, Multiple sclerosis, and Sudden Sensorineural hearing loss (SSHL). Five different databases (PubMed, Scopus, Web of science, Science Direct and Google Scholar) were independently screened. Publications in English were reviewed from 2000 to 2024. 
Results: Fifteen papers met the inclusion criteria for this study. Results of the study showed that the most common audiovestibular manifestation as a presenting symptom of MS was unilateral, moderate to profound, fluctuating, and SSHL across all frequencies (250 Hz–8000 Hz). Other symptoms include tinnitus, balance abnormalities, aural pain and aural fullness, which may accompany SSHL or occur independently. Demyelinating lesions associated with MS were suggested by results obtained from evoked potentials measurements, including auditory Brainstem Response (ABR), vestibular evoked myogenic potentials (VEMPs), and middle latency response (MLR).
Conclusion: We suggest that there is enough evidence to include evoked potentials complementary to MRI in the detection and monitoring of MS. As the review suggests evidence of involvement of the immune-mediated mechanisms of MS on peripheral structures like the inner ear, further clinical research is recommended to explore this mechanism.