Episodic vertigo, similar to that of Meniere's disease, can occasionally develop years to decades after an ear has suffered a profound sensorineural hearing loss. Although the pathogenesis of this process is unknown, it is theorized that delayed endolymphatic hydrops develops. An inflammatory reaction could cause obstruction of the endolymphatic duct or interfere with venous drainage from the region of the endolymphatic sac, leading to hydrops. This condition is reviewed, and two adult patients with severe episodic vertigo and a unilateral profound sensorineural hearing loss which occurred in childhood are presented. Their evaluation and management are discussed.