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A 35-year-old woman, previously well, presented with a sudden onset of giddiness for the previous 3 days. This was rotatory, persistent, not aggravated by positional or postural change and mildly alleviated on lying supine. Within a day of onset, she had developed bilateral moderate hearing loss. There was no limb weakness, sensory symptoms, facial pain, headache, dysphagia or dysarthria. Since the onset of symptoms, she had experienced occasional episodes of bilateral visual blurring, which would persist for hours, without associated oscillopsia. There had been no recent febrile illness, rash, travel or any similar illness in the family.