We are pleased that Sidorov et al found our article provocative, as our intention was to make internists aware of the associations found by otologists between metabolic abnormalities and vertigo. Since most patients with vertigo are initially seen and treated by their primary physicians, the possibility of abnormalities that may constitute risk factors for atherosclerosis being associated with vertigo may serve to further stimulate the evaluation and treatment of disorders of glucose, insulin, and lipid metabolism.
Sidorov et al raised certain questions about data that were not presented in our article and about the method of selection of patients. Our group of patients did not include alcoholics, nor were there instances of medication being associated with the vertigo state. Disequilibrium was identified when there was rombergism or a Quix body sway.1 We studied only patients with persistent vertigo that did not totally respond to or was resistant to medical