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Do you have multiple sclerosis and suffer from hearing problems? While not as common as symptoms like numbness, tingling, blurry vision and difficulties walking, hearing problems have been reported by people living with MS.

It has been reported that hearing loss affects about 6 percent of MS patients, with some experiencing hearing loss as their first symptom. To understand how MS may affect hearing, we first must understand how we hear.

In layman’s terms, the way we hear is that sounds are received through our ear canal. Those sounds then vibrate off our eardrum and those vibrations are translated into electronic signals. The electronic signals are then carried by the auditory nerve to the brain to be translated into sounds we recognize and understand. An MS lesion on your auditory nerve, or at other sites, can disrupt the auditory pathway, which could lead to hearing problems.

In addition to lesions on the auditory nerve or pathways, lesions on the brainstem are thought to be attributed to hearing problems and MS. The brainstem is the part of the brain that is involved in hearing, as well as vision and balance.

Did you know that sudden hearing problems can help signal a relapse? It stands to reason that since the brainstem controls hearing, vision, and balance that a change in hearing could signal that you may be having a relapse. The most common change in hearing is Tinnitus, or ringing in the ears. If you experience Tinnitus, or other hearing problems over a period of time, let your neurologist know of this change.

Hearing loss activity with MS can also be triggered by heat. Uthoff’s phenomenon refers to pseudo-exacerbations, or a minirelapse, that can happen when your body temperature rises like it can with the summer heat. Most people report vision problems with Uthoff’s phenomenon, but a change in body temperature can affect your hearing as well.

So what do you do if you experience hearing loss and MS? Here are five strategies to help address hearing loss associated with MS.

1. Rule out ear infections. Because hearing problems are not as common with MS, it is important to see a doctor to rule out other ear infections or problems that may occur.
2. Talk to your neurologist about your symptoms. If your hearing symptoms persist, it may not be due to your job or loud music you listened to when you were younger. Rather, it may be a lesion that is affecting your auditory nerve, auditory pathway or brainstem.
3. Get a brain MRI. An MRI will give the neurologist the information to see if the MS activity is affecting the auditory nerve, auditory pathway or brainstem. While they can be uncomfortable, claustrophobic, and expensive, MRIs give neurologists the clearest picture of what is going on with your MS.
4. Get a hearing screening or evaluation. Hearing screening and evaluations differ in complexity. A hearing screening is a pass/fail. If you fail, the recommendation is generally to see an audiologist for an in-depth hearing evaluation.
5. Get treatment. If your hearing loss is related to an MS relapse, the neurologist may prescribe treatment, like corticosteroids, to address the flare.

MS and hearing loss, although rare, is reported in 6 percent of the MS population. MS lesions on or near your auditory nerve, auditory pathway, or brainstem can cause hearing loss. A rise in temperature can also cause a pseudo exacerbation that affects your hearing. If you are experiencing hearing problems, it is important to check with your doctor to rule out other hearing problem or infections. If the hearing problem is associated with your MS, consult your neurologist for options on how to manage the symptoms.