TY - JOUR
T1 - Hearing abnormalities in multiple sclerosis
T2 - clinical semiology and pathophysiologic mechanisms
AU - Cruz, Roberto A.
AU - Varkey, Thomas
AU - Flavia, Ana
AU - Samways, Ana Paula Amatuzzi
AU - Garza, Alejandro
AU - Greenlee, Gabrielle
AU - Friess, Margaret
AU - Sconzert, Jayne
AU - Aijaz, Afaf
AU - Arruda, Walter
AU - Khouri, Juliana
AU - Ellington, Kent
AU - Frohman, Teresa C.
AU - Frohman, Elliot M.
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
PY - 2022/5
Y1 - 2022/5
N2 - Auditory manifestations from multiple sclerosis (MS) are not as common as the well-recognized sentinel exacerbations of optic neuritis, partial myelitis, motor weakness, vertiginous episodes, heat intolerance, and eye movement abnormalities. This paper discusses four cases of auditory changes, secondary to MS, and describes the first case, to our knowledge, of palinacousis, the perseveration of hearing, despite cessation of the sound stimulus. For each we characterize the initial complaint, the diagnostic work up, and ultimately, underscore the individualized treatment interventions, that allowed us to achieve a remission in all four cases. Individually codifying the treatment regimens served to mitigate, if not to abolish, the clinical derangements in hearing. Special attention is focused upon examination of the clinical manifestations and the pathophysiologic mechanisms which are responsible for them. We further emphasize the differential diagnostic considerations, and physical exam findings, along with the results of laboratory testing, neuro-imaging sequences, and lesion localization. Taken together, such information is germane to organizing cogently coherent strategic treatment plan(s). We believe that this small case series represents a clinically pragmatic example of ‘precision medicine’; a principal theme and goal throughout this paper, the achievement of such in MS, but also as an illustration for the assessment and management schema for neuroimmunologic disorders in general.
AB - Auditory manifestations from multiple sclerosis (MS) are not as common as the well-recognized sentinel exacerbations of optic neuritis, partial myelitis, motor weakness, vertiginous episodes, heat intolerance, and eye movement abnormalities. This paper discusses four cases of auditory changes, secondary to MS, and describes the first case, to our knowledge, of palinacousis, the perseveration of hearing, despite cessation of the sound stimulus. For each we characterize the initial complaint, the diagnostic work up, and ultimately, underscore the individualized treatment interventions, that allowed us to achieve a remission in all four cases. Individually codifying the treatment regimens served to mitigate, if not to abolish, the clinical derangements in hearing. Special attention is focused upon examination of the clinical manifestations and the pathophysiologic mechanisms which are responsible for them. We further emphasize the differential diagnostic considerations, and physical exam findings, along with the results of laboratory testing, neuro-imaging sequences, and lesion localization. Taken together, such information is germane to organizing cogently coherent strategic treatment plan(s). We believe that this small case series represents a clinically pragmatic example of ‘precision medicine’; a principal theme and goal throughout this paper, the achievement of such in MS, but also as an illustration for the assessment and management schema for neuroimmunologic disorders in general.
KW - Auditory nuclei
KW - Brodmann area 41
KW - Cranial nerve VIII
KW - Heschl’s gyrus
KW - Inferior colliculus
KW - Lateral lemniscus
KW - Medial geniculate nucleus
KW - Multiple sclerosis
KW - Palinacousis
KW - Sensorineural hearing loss
KW - Superior temporal gyrus
KW - Trapezoid body
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U2 - 10.1007/s00415-021-10915-w
DO - 10.1007/s00415-021-10915-w
M3 - Article
C2 - 34999960
AN - SCOPUS:85122697781
SN - 0340-5354
VL - 269
SP - 2792
EP - 2805
JO - Journal of neurology
JF - Journal of neurology
IS - 5
ER -