Decompensated labyrinthine weakness presenting as de novo peripheral vertigo: a discrete clinical entity?

Objective: A distinct subgroup of patients, presenting with apparently spontaneous onset of vertigo, is described.
Results: Although vestibular evaluation revealed caloric weakness, the proximate cause of vertigo was not labyrinthine dysfunction, but rather the loss of vestibular compensation for an older and previously compensated labyrinthine injury.
Conclusion: Instead of addressing the vestibular weakness, effective management needs to focus on the condition that has caused the loss of compensation.