I. Concept: Geriatric vertigo is a comprehensive name for the occurrence of vertigo and balance dysfunction in the elderly population, and it is not a separate disease. It is both a result of degenerative changes of the vestibular system in old age and a clinical manifestation of many vertigo disorders. Common diseases of senile vertigo: benign paroxysmal positional vertigo, labyrinthitis, Meniere’s disease, exolymphatic leakage, otosclerosis, vestibular neuritis, ototoxic drug intoxication, cerebellopontocerebellar horn tumor, vascular vertigo, multiple sclerosis, Parkinson’s disease, hyperventilation syndrome, glucose abnormalities, etc. Pathogenesis: As the age of vestibular system increases, the blood supply of vestibular system decreases. (vestibular function) ↓ K peripheral nerve conduction velocity is slowed, and proprioception is reduced during passive movement of lower limb joints. Decreased sensitivity of vision and slowed visual response to postural control. In conclusion, senile vertigo, leading to easy falls, is certainly caused by the presence of balance disorders, but it is related to senile vestibular hypofunction, diminished visual acuity, diminished proprioceptive function, diminished physical strength, diminished muscle strength, defective sensorimotor system, and weakened postural reflexes. Clinical manifestations: In addition to vertigo symptoms, most of them are accompanied by headache, nausea, vomiting, tinnitus and other symptoms. The vestibular function is reflected by unstable standing when eyes are closed, especially when standing on one leg, reduced heat test function, weakened response to rotation test, and abnormal posture chart examination. Differential diagnosis: (a) Peripheral vestibular lesions involving vestibular end organs and vestibular nerves, including Meniere’s disease, vestibular neuritis, benign paroxysmal positional vertigo, etc. Meniere’s disease: Initially, the ears feel swollen, tinnitus or hearing loss, followed by rotational vertigo, positional imbalance, nystagmus, nausea and vomiting. Symptoms can last 0.5 to 24 h. Fluctuating episodes. (2) Vestibular neuritis: acute attack with prolonged severe vertigo (up to 6 weeks), aggravated by head movements, possibly accompanied by nystagmus, positional imbalance, nausea and vomiting, usually without cochlear symptoms, without hearing impairment, and rarely recurring after recovery. The onset of the disease is often accompanied by symptoms of infection (mostly upper respiratory tract infection), probably a viral infection. (3) Benign paroxysmal positional vertigo: A rapid change in the position of the head precipitates a brief episode of vertigo, which is confirmed by a position test. (ii) Central neurological lesions These lesions include a group of completely different pathological causes: severe cervical spondylosis (vertebral artery type), episodic falls, cerebrovascular lesions, intracranial tumors, basilar migraine, multiple cerebral sclerosis, etc., which can be confirmed by clinical examination and ancillary tests. Cerebrovascular disease, hypertension, and cervical spondylosis are important factors causing vertigo syndrome in the elderly. Under the action of certain causative factors, the combination of multiple factors often aggravates the disease, which is often easy to recur and lasts for a long time. The single cause such as vestibular neuritis and other peripheral vertigo is rare in elderly patients. V. Treatment 1. General treatment: In acute attacks, the patient should be absolutely bedridden. 2. Etiological treatment: If there is a clear disease causing vertigo, the original disease should be treated, but the medication should be used with caution, paying attention to the side effects and should not be overdosed. (1) Anticholinergics and monoaminergics, such as atropine, scopolamine, amphetamine, etc. (2) Antihistamines, such as diphenhydramine, promethazine (finasteride), etc. (3) Anti-dopamines, such as chlorpromazine, etc. Pay attention to the principle of medication, the choice of drugs and the combination of drugs should be based on the size of the effect of each drug on mo a disease, the size of the side effects, and whether it is the same kind of drugs, combined application can cause an overdose of the effect, the severity of symptoms and the time course and other factors. 4.Balance rehabilitation treatment, the purpose of which is to reduce the risk of falls. (1) Educate patients to learn to adapt to or deal with their own balance disorders in daily life to increase their own safety. (2) Physical training, such as physical flexibility training, increase physical strength training, etc. (3) Balance training, using the Cawthorne-Cooksey modified training method. (4) Improvement of the whole body, appropriate aerobic exercise, 15 minutes a day, 3 to 4 times a week