Spring 08 Week 4

A female student came to clinic to seek help for a fluctuating hearing loss. She describes her hearing as intermittent and fluctuating. Approximately four years ago, she had mononucleosis symptoms; however, test results were negative. She reports a constant feeling of aural fullness and tinnitus only with the decrease in hearing ability.

Clear ear canals and intact tympanic membranes were observed bilaterally. Normal, Type A tympanograms were measured. Pure tone thresholds using insert earphones were found to be within normal limits, less than 25 dB HL across all frequencies bilaterally. Speech recognition thresholds (SRT) were in excellent agreement with the pure tone averages. SRT scores were 5 dB bilaterally. Speech discrimination was 100% bilaterally. On the day of testing, her hearing is considered to be normal.

Although diagnosis can not be made just from the results, the patient described a case history that suggest multiple sclerosis. The report was sent to her primary care physician with a side note of fluctuating hearing loss is a symptom of MS. Which you can find a list of symptoms here:

http://www.nationalmssociety.org/about-multiple-sclerosis/symptoms/index.aspx

The article that I found tested one female with known MS. The participant was in later stages of MS and had more severe symptoms than that of the patient seen. However, it gives valuable information about the use of audiological assessment used for diagnosing MS. The participant had sudden bilateral sensorineural hearing loss and vertigo. She was tested with audiometry, AEPs, bithermal calorics, and MRI.

Young-Mi Oh et al. (2008). Sequential bilateral hearing loss in multiple sclerosis.
Annals of Otolarngology, 117: 186-191.

http://web.ebscohost.com/ehost/pdf?vid=1&hid=104&sid=ff919d2a-aafa-4afc-9cfe-7225021250c1%40sessionmgr107