Bilateral vestibulopathy has had several names, paralleling growing numbers of publications and interest in its pathophysiology and treatment. The condition was formerly Dandy syndrome, eponymously associated with neurosurgeon Walter Dandy who worked at the Johns Hopkins Hospital from 1918 to 1946. Having developed expertise in vestibular schwannoma surgery, Dandy became interested in vestibular nerve section to treat Meniere's disease. He achieved early success at controlling vertigo in patients with Meniere's disease after unilateral sectioning of the vestibular nerve, and then began performing bilateral vestibular nerve section. The first descriptions of the consequences of this surgery were in 1936 by neurologist Frank Ford and neuro-ophthalmologist Frank Walsh, who both worked with Dandy at the Johns Hopkins Hospital (1). They noted in a patient:“Objects seemed to move before his eyes unless his head was kept perfectly still.” Dandy later synthesized these cases and reported them himself in 1941, leading to the term Dandy syndrome (2).

Although we understand the implications of cutting both vestibular nerves today, at the time, many clinicians had a poor knowledge of the role of the vestibular system. A popular notion held that the vestibular system was vestigial. Prominent English physician Edmund Hobhouse noted in a 1924 Lancet editorial:“We are driven to the somewhat painful conclusion that in the semicircular canals man possesses a beautiful and complex mechanism which has been superseded by higher development, and whose only positive function now is to produce some of the most disabling and distressing symptoms which the human body can experience; moreover, this mechanism is so bound up with the organ of hearing that it is impossible to remove it without inflicting the penalty of deafness (3).” If vestibular testing and disease produces vertigo and nausea in those with intact labyrinthine function, and no symptoms in those without, Hobhouse argued, then the labyrinth is superfluous. Since airplane pilots could be led asunder by normal vestibular perceptions, the United States military even expressed interest in bilateral vestibulopathy to make better pilots (4). Dandy began performing vestibular nerve section for Meniere's disease in 1924, the same year as Hobhouse's editorial (5), later expanding to sectioning both vestibular nerves (6). Dandy comments in his 1934 series:“One is amazed that almost no symptoms are induced by the abrupt loss of both semicircular canals in man.” and provocatively states “It would be interesting indeed, to know whether this patient would be subject to seasickness.” Ford and Walsh'1938 article describing Dandy's patients was in response to the popular belief that an intact vestibular system could only do harm.