Audiovestibular findings according to the subtypes of multiple sclerosis

Fatmanur Uysal; Selim S. Erbek; Alper Köycü; Osman Halit Çam; Meliha Güleryüz

doi:10.55697/tnd.2025.442

Fatmanur Uysal¹, Selim S. Erbek², Alper Köycü², Osman Halit Çam³, Meliha Güleryüz⁴

¹Department of Audiology, Doğuş University Vocational School, İstanbul, Türkiye
²Department of Otolaryngology, Başkent University Faculty of Medicine, Ankara, Türkiye
³Department of Otolaryngology, Acıbadem Hospital, İstanbul, Türkiye
⁴Department of Neurology, Başkent University Hospital, İstanbul, Türkiye

Keywords: Dizziness Handicap Inventory, multiple sclerosis, vestibular.

Abstract

Objectives: This study aimed to evaluate auditory and vestibular function across different clinical subtypes of multiple sclerosis (MS) using both objective testing and patient-reported outcomes.

Patients and methods: The study was conducted between June 2020 and March 2021. A total of 50 adults (26 males, 34 females; mean age, 45.7±13.7 years; range, 20 to 70 years) were included and categorized into five groups: clinically isolated syndrome, relapsing-remitting MS, secondary progressive MS (SPMS), primary progressive MS (PPMS), and healthy controls. Assessments included pure tone audiometry, immittance testing, videonystagmography with oculomotor and positional subtests, and video head impulse test. Dizziness Handicap Inventory was used to assess subjective balance complaints.

Results: Significantly elevated hearing thresholds were observed in the SPMS group at 6000 to 8000 Hz, and in the PPMS group at 250, 1000, and 6000 Hz (p<0.005). Oculomotor abnormalities, particularly in saccade and smooth pursuit, were more frequent in PPMS (p<0.005). No significant differences were detected in video head impulse test gain values or positional nystagmus between groups (p>0.005). Dizziness Handicap Inventory scores were significantly higher in the SPMS and PPMS groups compared to other groups, indicating greater subjective disability (p<0.005).

Conclusion: Progressive MS subtypes (SPMS and PPMS) showed greater auditory and vestibular impairment than the other forms. These findings emphasized the need for routine audiovestibular assessments and support integrating patient-reported outcomes such as the Dizziness Handicap Inventory into clinical follow-up.

Cite this article as: Uysal F, Erbek SS, Köycü A, Çam OH, Güleryüz M. Audiovestibular findings according to the subtypes of multiple sclerosis. Turk J Neurol 2025;31(4):435-442. doi: 10.55697/tnd.2025.442.