急性難聴から診断に至った多発性硬化症の1例

A case of multiple sclerosis presenting with sudden sensorineural hearing loss

はじめに

　多発性硬化症（multiple sclerosis：MS）は最も一般的な脱髄性疾患であり，多彩な神経症状を呈する。MSでは視神経炎が最も多い症候であるが，耳鼻咽喉科領域でも顔面神経麻痺，難聴，めまい，声帯麻痺などを伴うこともある。今回，急性難聴で当科に紹介となり，MSの診断に至った症例を経験したので，若干の文献的考察を加えて報告する。

　Although multiple sclerosis is a disease that manifests with multiple neurologic symptoms, it rarely presents with isolated acute hearing loss. Here, we report a case of multiple sclerosis in a 27-year-old man presenting with sudden sensorineural hearing loss. Despite experiencing severe sensorineural hearing loss, distortion product optoacoustic emissions amplitude was detected. Abnormal auditory evoked brainstem response and magnetic resonance imaging revealed that it is the first attack of multiple sclerosis. Treatment with steroid pulse therapy, immunoadsorption, and plasmapheresis completely restored his hearing. This case highlights the importance of considering multiple sclerosis in patients with acute sensorineural hearing loss.