Multiple sclerosis as an under-recognized cause of acute vertigo: clinical and pathophysiologic insights

Multiple sclerosis (MS) is an autoimmune disorder that frequently presents with acute neurological symptoms during relapsing-remitting phases. While motor, sensory, and visual deficits are widely recognized manifestations of relapses, vestibular symptoms such as acute vertigo, dizziness, and imbalance are comparatively under-recognized and often pose diagnostic challenges....

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Clinicians evaluating acute vertigo should include MS in the differential diagnosis, especially in younger patients with other neurological features — this review reinforces existing neurological guidance rather than introducing new practice-changing evidence.

MS-related vertigo is frequently attributed to inner ear or primary vestibular causes, and missing the diagnosis delays disease-modifying treatment — heightened awareness among audiologists and neurotologists has direct patient safety implications.

1. 01Narrative review in Frontiers in Neurology (doi: 10.3389/fneur.2026.1888822) on MS as an under-recognized cause of acute vertigo.
2. 02Covers clinical presentation of MS-related vertigo during relapsing-remitting phases.
3. 03Explains pathophysiological mechanisms by which MS lesions produce vestibular symptoms.
4. 04Encourages clinicians to broaden their differential diagnosis for acute vertigo beyond peripheral causes.
5. 05No new primary data; synthesizes existing clinical and mechanistic literature.

PMID

42719211

DOI

10.3389/fneur.2026.1888822.

Journal

Frontiers in Neurology

Publication type

review

Evidence level

5

Population

Patients with acute vertigo and multiple sclerosis (reviewed literature)

Intervention

Review of MS clinical presentation and pathophysiology as a cause of acute vertigo