It depends which symptom is meant. The vertigo attacks often become less frequent and may stop altogether after some years, while hearing in the affected ear tends to decline and that loss is usually permanent. The condition can therefore improve and worsen at the same time.
It depends which symptom is meant. The vertigo attacks often become less frequent and may stop altogether after some years, while hearing in the affected ear tends to decline and that loss is usually permanent. The condition can therefore improve and worsen at the same time.
The disorder combines episodic vertigo with hearing loss, tinnitus and a sensation of fullness in the affected ear. Attacks last from tens of minutes to several hours, which distinguishes them from the seconds of positional vertigo and the days of vestibular neuritis. Early on, hearing fluctuates and often recovers between attacks. Over years the two symptoms separate: the attacks tend to become less frequent, while the hearing loss becomes fixed. Asking whether the condition is worsening therefore needs the question split in two.
Long-term follow-up describes attacks diminishing and in many people ceasing after a period of years, a course sometimes called burnout. It is unpredictable, and it does not mean the ear has recovered; balance function in that ear may in fact be reduced, which is part of why the attacks stop. Some people are left with a persistent mild unsteadiness rather than discrete attacks. That change is worth recognising as a different problem, because it is managed with vestibular rehabilitation rather than with attack treatment.
Hearing loss in this condition typically begins in the low frequencies and fluctuates, then flattens and becomes permanent as the years pass. It is monitored with repeated audiometry, which is arranged with audiology rather than performed at these offices. Hearing aids are effective for many people once the loss is established, and untreated hearing loss has consequences beyond the ear, including on cognitive testing and social engagement. Bilateral involvement develops in a minority and changes the management considerably.
VNG balance testing is performed in the office at both locations and assesses how the balance organs and their central connections are working, which helps distinguish this condition from other causes of recurrent vertigo. Positional testing is done at the same visit where relevant. Audiometry is arranged with audiology. MRI is arranged at an imaging centre when it is needed to exclude another cause of the same symptoms, and the report is reviewed with you here.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: Ménière disease; MedlinePlus: dizziness and vertigo; National Institute of Neurological Disorders and Stroke.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.