The investigated parameters included spontaneous nystagmus, head-shaking nystagmus, positional nystagmus during the Dix-Hallpike and head-roll maneuvers, nystagmus with the Valsalva maneuver, the Tullio phenomenon after hyperventilation and exposure to 3 kHz at 110 dB, and eye movements after mastoid vibration at 100 Hz.
The diagnosis of this disorder is based on the presence of characteristic symptoms such as dizziness, the Tullio phenomenon, positional vertigo, pulsatile tinnitus, and conductive and/or sensorineural hearing loss.
We report a case of acquired syphilis with symptoms of Tullio phenomenon in a patient concurrently diagnosed with HIV infection, The resurgence of syphilis in HIV-positive groups at high risk has public health implications for prevention of both diseases.
The physiologic underpinnings of the Tullio phenomenon were first described in 1929, when Tullio noted that experimentally induced fenestrations in the bony capsule of the lateral semicircular canals of pigeons caused the canals to be sound-responsive, inducing vestibular activation (11,12).
The Tullio phenomenon is seen in a range of clinical contexts, including congenital deafness, Meniere disease, suppurative middle ear disease, and spirochetal infections, such as syphilis or Lyme disease.
This case report describes a patient who had Tullio phenomenon as the index symptom of neurosyphilis with previously undiagnosed HIV infection.