The human body relies on three major sensory systems – vestibular, visual and proprioceptive – to maintain balance, with the vestibular system playing the most important role. The most common symptom in people with vestibular disorders is vertigo. Unlike dizziness, vertigo is an illusion that changes the spatial position of oneself in relation to surrounding objects, and is divided into rotational vertigo and body tilt. Rotational vertigo is characterized by the rotation of surrounding objects when the eyes are open and the rotation of oneself when the eyes are closed, and it suggests abnormalities in the semicircular canal or its central projection. In contrast, body tilting sensation is mostly tilting and floating sensation, which suggests a lesion of the locus coeruleus in the inner ear. When the bilateral vestibular afferent information is inconsistent, the patient feels vertigo subjectively and shows balance disturbance objectively. According to the lesion site, vertigo is mainly divided into vestibular vertigo and non-vestibular vertigo, and the former is divided into peripheral vertigo and central vertigo. 1. Peripheral vertigo refers to vertigo caused when the lesion is located in the peripheral vestibular system, which includes the following characteristics: (1) Most of them are rotational vertigo. (2) Short duration of vertigo attack (several minutes to hours to days). (3) Phenomena of vestibular coordination: Phenomena of vegetative nervous disorders consistent with the degree of vertigo, such as nausea, vomiting, and cold sweats; the degree of balance disorders consistent with vertigo. (4) Nystagmus is brief, fine and rapid, mostly horizontal rotational in nature. (5) It is often accompanied by deafness and tinnitus. Common peripheral vertigo: Meniere’s disease, vestibular neuronitis, sudden deafness, benign paroxysmal positional vertigo (BPPV), inner ear ischemia, labyrinthitis, other peripheral vertigo: pharmacological (drug history + deafness + vertigo), Hunt’s syndrome (ear banding + vertigo + facial palsy), otosclerosis (conductive deafness with normal tympanic membrane), autoimmune inner ear disease (fluctuating vertigo, hormone (effective). 2. Central vertigo refers to vertigo caused when the lesion is located in the central vestibular system, which includes the following characteristics: (1) Balance disorder is the main cause, and vertigo is mild. (2) It lasts for a long time (tens of days to months). (3) Vestibular incoordination phenomenon: the degree of vertigo is not consistent with the degree of plant nerve dysfunction, and the degree of balance disorder is not consistent with vertigo. (4) Nystagmus is persistent, coarse, vertical, oblique movement, and separation. (5) It is often accompanied by brainstem ischemia such as black eyes and golden blossoms, or headache. Common central vertigo: vertebrobasilar artery insufficiency, transient ischemic attack (TIA), other central vertigo: epilepsy (with EEG abnormalities), cerebellar lesions (ataxia), multiple sclerosis (multicranial neurodegeneration), cerebral infarction. 3. Non-vestibular vertigo: including cervical vertigo (attacks when twisting the neck, vertebral artery stenosis), vegetative nerve dysfunction (menopause, neurosis), ophthalmic vertigo.