Dr Drachman is Professor and Chairman, Department of Neurology, University of Massachusetts Medical Center, Worcester.
Clinical Crossroads at Beth Israel Deaconess Medical Center is
produced and edited by Thomas L. Delbanco, MD, Jennifer
Daley, MD, and Richard A. Parker, MD; Erin E. Hartman, MS, is managing
editor. Clinical Crossroads section editor: Margaret A. Winker, MD,
Senior Editor, JAMA.
DR PARKER:Mr D is a 69-year-old man troubled by dizziness. He is retired from his job as
building superintendent for a public school. He is married, lives in
the Boston, Mass, suburbs, and has managed Medicare insurance.
Mr D dates the onset of his dizziness to 1994, when the symptoms were
predominantly vertiginous. He described the sensation as "everything
is moving" and "like I had too much to drink." These episodes
lasted 1 to 2 hours, occurred several times per week, and often came on
suddenly, such as when arising in the middle of the night. At that
time, use of meclizine hydrochloride seemed to decrease the symptoms.
Results of a magnetic resonance imaging (MRI) scan of the brain at that
time were normal.
Drachman DA. A 69-Year-Old Man With Chronic Dizziness. JAMA. 1998;280(24):2111-2118. doi:10.1001/jama.280.24.2111