Dizziness occurs in more than 90% of people in daily life. In mild cases, transient dizziness resolves spontaneously, while in severe cases it is accompanied by a series of vestibular reflexes. Nausea, vomiting, fear of sound, fear of light, and great fear. Patients with dizziness include old, middle-aged and young people of all ages; the forms are diverse, including dizzy, spinning dizziness and light-headed dizziness; while young doctors seem to show a certain pattern when diagnosing patients with vertigo: old patients – cerebral blood supply deficiency, middle-aged patients – cervical spondylosis, women – Meniere’s syndrome… … It is true that vertigo is a very common clinical symptom, but the diagnosis of vertigo is not simple at all. It is said that a detailed history taking can diagnose more than 70% of vertigo. So, how do we take a patient’s history in the diagnostic process? The first step to distinguish “real” vertigo from “fake” vertigo is to ask the patient whether he or she is dizzy or vertiginous. Vertigo refers to the sensation of rotation or oscillation of oneself or the environment, and is a kind of motion hallucination. Many patients with vertigo describe their attacks as “like they are going to fly out.” It is very painful; dizziness mainly manifests itself as a sense of instability and is often accompanied by a sense of mental unclearness, i.e. dizziness. Secondly, vertigo is also divided into true and false. “Pseudovertigo, also known as cerebral vertigo, is mostly caused by the cortical centers of the balance triad (visual, proprioceptive and vestibular) or by systemic diseases that affect the above-mentioned cortical centers, and the patient feels “dizzy” without a clear sense of rotation; for example Pseudovertigo” can be caused by hypertension, fever, anemia, etc. “True vertigo” is caused by a triad of balance lesions, and there is a clear sense of rotation or body movement. Once we can distinguish between “true and false vertigo”, we can generally determine whether the patient has vestibular or non-vestibular vertigo. Of course, this is not enough for the diagnosis of vertigo. We also need to identify the type of vertigo by taking further history at the same time.1. Triggering factors: change of head position: BPPV, posterior cranial fossa tumor and migrainous vertigo, etc.; menstruation-related or sleep deprivation: migrainous vertigo, etc.; tile movement: superior hemimelia and ectolymphatic fistula; standing position: postural hypotension, etc.; movement of objects in the visual field: bilateral vestibular disease.2. Duration: several seconds or tens of seconds BPPV, vestibular paroxysm, varicose vertigo, cervical vertigo, epileptic vertigo and pre-syncope; minutes: TIA, migrainous vertigo, vestibular paroxysm, epileptic vertigo, superior semicircular fissure, varicose vertigo, etc.; more than 20min: Meniere’s disease and migrainous vertigo; days: stroke, vestibular neuritis and migrainous vertigo, etc.; persistent dizziness: bilateral vestibular hypofunction and 3. Accompanying symptoms: cerebral nerve or limb paralysis: posterior cranial fossa or skull base lesions; deafness, tinnitus or swelling: Meniere’s disease, auditory neuroma, sudden deafness, labyrinthitis, exolymphatic fistula, large vestibular aqueduct syndrome, vestibular paroxysm, otosclerosis and autoimmune inner ear disease; photophobia, headache or visual aura: migrainous vertigo. 4. Frequency of attacks: single or first: vestibular neuritis, brainstem or cerebellar stroke or migrainous vertigo. brainstem or cerebellar stroke or demyelination, first-episode migrainous vertigo, first-episode Meniere’s disease, labyrinthitis, exolymphatic fistula, and pharmacologic. Recurrent: BPPV, Meniere’s disease, TIA, migrainous vertigo, vestibular paroxysm, exolymphatic fistula, epileptic vertigo, autoimmune inner ear disease, auditory neuroma, otolithic dysfunction, unilateral hypoplastic vestibular insufficiency. 5. History of previous medications: carbamazepine – reversible cerebellar damage; long-term application of phenytoin sodium – cerebellar degeneration, long-term exposure to heavy metals such as mercury, lead, arsenic – damage to the cochlea, the Vestibular apparatus and cerebellum, organic solvents formaldehyde, xylene, styrene, trichloromethane – damage to the cerebellum.