Three important judgments: primary and secondary, true and false, central and peripheral. Zhang Hongwen, Ophthalmology Department, Tianjin Jixian People’s Hospital 1. Judgment of vertigo in clinical manifestations: (1) vertigo as the main symptom (often suggesting vestibular vertigo) – simply having: vertigo, vomiting, panic; (2) vertigo as the secondary symptom (often suggesting post-central circulation stroke) – -in addition to vertigo, which cannot be considered a chief complaint, have: ocular symptoms, altered consciousness, ataxia, bulbar palsy, long bundle signs, etc. 2. Determination of true and false: (1) true vertigo – often persistent, systemic vertigo; (2) false vertigo – often transient, with emphasis on excluding diseases other than neurological. For example, inadequate blood supply (cardiogenic, hypotensive, postural, cervical); emotional (great joy, anger, sadness); hyperventilation; hysteria. 3. Judgment of central and peripheral: (1) Central vertigo: vertigo is milder, often accompanied by other clinical manifestations of central diseases, and may be more prominent. (2) Peripheral vertigo: vertigo is intense and not accompanied by other clinical manifestations of central diseases, with emphasis on six diseases: ①. Meniere’s disease ②. Vestibular neuronitis ③. Otolithic sclerosis ④. Migraine equilibrium – also called migraine aura without headache, migraine without headache. Migraine aura without headache. ⑤. Panic attacks ⑥. Migraine headache (VBI). Having ruled out the first 5 disorders, the rest are thrown into the holding tank that is VBI.