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Auditory dysfunction caused by multiple sclerosis: detection with MR imaging
J K Curé1, L D Cromwell, J L Case
1Department of Radiology, Dartmouth-Hitchcock Medical Center, Hanover, NH 03756.
Abstract:
We reviewed the MR examinations of 167 patients who presented over a 3-year period with a chief symptom of hearing loss and/or tinnitus. In 14 of these patients the only MR abnormality was the presence of multiple parenchymal high-signal foci on T2-weighted images. Nine of the 14 had clinical evidence of multiple sclerosis; the remaining five had no clinical evidence of multiple sclerosis. Lesions in the auditory pathways, potentially responsible for the patients' symptoms, were identified in only five cases. We recommend T2-weighted images of the whole brain in addition to T1-weighted images of the internal auditory canals and cerebellopontine angles in patients with hearing loss. In some patients, lesions found at higher levels in the periventricular white matter may provide the only clue to the origin of auditory abnormalities.
Insights
Magnetic resonance imaging (MRI) can reveal multiple brain lesions in patients with hearing loss or tinnitus. Whole-brain T2-weighted MRI is recommended to identify potential causes, including multiple sclerosis.
Area of Science:
- Neurology
- Radiology
- Otolaryngology
Background:
- Hearing loss and tinnitus are common symptoms that can be associated with various neurological conditions.
- Magnetic resonance imaging (MRI) is a key diagnostic tool for evaluating the auditory pathways and brain parenchyma.
Purpose of the Study:
- To investigate the utility of MRI in identifying the cause of hearing loss and tinnitus.
- To determine if T2-weighted whole-brain MRI can reveal abnormalities not visible with standard imaging protocols.
Main Methods:
- Retrospective review of 167 patients with hearing loss and/or tinnitus undergoing MRI over a 3-year period.
- Analysis of MRI findings, focusing on T2-weighted images for parenchymal high-signal foci and T1-weighted images of the internal auditory canals and cerebellopontine angles.
Main Results:
- 14 out of 167 patients (8.4%) had multiple parenchymal high-signal foci on T2-weighted images as the sole MRI abnormality.
- Nine of these 14 patients had clinical evidence of multiple sclerosis; five did not.
- Specific lesions in the auditory pathways were identified in only five cases, suggesting higher-level brain abnormalities may be responsible.
Conclusions:
- T2-weighted whole-brain MRI is valuable for patients with hearing loss and tinnitus, potentially revealing multiple sclerosis or other white matter lesions.
- Standard MRI protocols focusing only on the internal auditory canals may miss crucial findings in the brain parenchyma.
- Comprehensive MRI evaluation, including whole-brain T2-weighted sequences, can aid in diagnosing the underlying cause of auditory symptoms.