Unilateral sudden sensorineural hearing loss as the presenting symptom of multiple sclerosis in adolescent: Neuro-otologic manifestations, pathogenesis, and localization

Sudden sensorineural hearing loss (SSNHL) is a rare initial complaint of multiple sclerosis (MS) in adolescent. We present the case of a 14-year-old girl presented with right SSNHL as an initial symptom in MS and recovery of hearing with time compatible to the MRI finding. It clearly identified that the pathogenesis of unilateral SSNHL in the patient with MS favors CNS demyelination, which may be accompanied with cytogenic edema, involving the intraaxial portion of the cochlear nerve and nerve fibers near cochlear nucleus. Besides, in adolescent with sudden hearing loss, multiple sclerosis should be included in the differential diagnosis.