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1. Characterized by recurrent attacks of vertigo associated with intermittent tinnitus that begins at 20-40 years of age.

2. Triad of episodic vertigo (A/W nausea & vomiting) and tinnitus, with low-frequency hearing loss after recurrent episodes.

3. Pathology - increase in the volume of endolymph and distention of the endolymphatic system (endolymphatic hydrops), partly related to salt intake.

4. If hearing loss is present at diagnosis, exclude neurosyphilis as a cause by checking a serum VDRL or RPR.

5. Anti-histamines, anti-emetics, and sedatives are used in acute episodes.

6. Chronic treatment includes eradicating caffeine and reducing the intake of salt, alcohol, nicotine, and MSG. Thiazide diuretics are used when spells continue after dietary modification. 95% of patients get their disease under control and function normally.

7. For recalcitrant disease, endolymphatic sac surgery, surgical labyrinthectomy, and vestibular nerve sections remain options.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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