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Clinical Crossroads
December 23/30, 1998

A 69-Year-Old Man With Chronic Dizziness

Author Affiliations

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.

JAMA. 1998;280(24):2111-2118. doi:10.1001/jama.280.24.2111

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.

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