< positive > 1 Case Information The patient, a 63-year-old male, was admitted to the hospital due to episodic vertigo, left tinnitus, and decreased hearing in the left ear for 3 months. Three months before admission (February 2022), the patient suddenly experienced vertigo accompanied by left tinnitus, ear congestion, and decreased hearing in the left ear. The rotational vertigo was episodic, lasting about 2 hours per episode. The patient felt that the vertigo worsened when changing positions and opening the eyes, and improved slightly after lying in bed. He was treated at a local hospital. Middle ear CT revealed: 1. No abnormalities in bilateral middle ear mastoids; 2. Deviated nasal septum, inflammatory changes in bilateral maxillary and ethmoid sinuses; cranial and cervical MRI revealed: 1. A few ischemic lesions under the bilateral frontal cortex; 2. Cervical osteophytosis; 3. Degeneration of C2-T3 intervertebral discs; mild posterior protrusion of C3-7 intervertebral discs.