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Comment & Response
August 14, 2018

Neurological Symptoms in US Government Personnel in Cuba

Author Affiliations
  • 1Ear and Balance Institute, Covington, Louisiana
  • 2Department of Otolaryngology–Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
JAMA. 2018;320(6):603-604. doi:10.1001/jama.2018.8713

To the Editor In the study of 21 US government personnel who experienced a suspected sonic weapon attack in Cuba,1 the patients’ symptoms could be explained by unilateral or bilateral peripheral labyrinthine injury, and further investigation is warranted. Our differential diagnosis includes (1) labyrinthine concussion, (2) delayed endolymphatic hydrops, (3) benign paroxysmal positional vertigo, (4) perilymphatic fistula, (5) new onset of symptoms from bony labyrinthine dehiscence, (6) malingering, and (7) neuropsychological abnormalities secondary to vestibulopathy. Unfortunately, testing to identify these entities was not reported.