1. Meniere’s syndrome The disease is a disorder of lymphatic metabolism in the inner ear, with sympathetic hyperexcitability as the main symptom, such as headache, vertigo, nausea, vomiting, tinnitus and deafness. The disease is characterized by sympathetic hyperexcitation, such as headache, vertigo, nausea, vomiting, tinnitus, deafness, nystagmus, slow pulse and low blood pressure. However, its attacks are related to cerebral cortex dysfunction, excessive fatigue, sleep deprivation and mood swings, not induced by neck activities, and there are no symptoms after remission; the attacks come rapidly and last for hours to days, unlike cervical spondylosis which is transient; there are no neurological and brainstem ischemic signs; there is regular horizontal nystagmus during the attack period. Subclavian steal syn-drome is an obstructive lesion of the subclavian artery, such as atherosclerosis, congenital malformation, trauma, thrombosis, etc., which causes the formation of collateral circulation between the vertebral artery, common carotid artery and the arteries of the upper extremity, and when the upper extremity moves, a large amount of cerebral blood flow reverses to the upper extremity, thus producing cerebral ischemic signs, such as weakness and pain. The radial artery pulsation is weakened or disappeared, and the fingers are clamped; the blood pressure on the affected side is low, and the systolic pressure can be 2.7~9.3kPa different; the movement of the affected limb can induce it; a systolic murmur can be heard in the supraclavicular fossa, and arteriography can confirm the diagnosis. 3.Embolism of the internal auditory artery in the ear Embolism of the internal auditory artery can cause sudden tinnitus and deafness and vertigo, and the symptoms are severe and persistent for several years or even for life. 4.Cerebral arteriosclerosis Cerebral arteriosclerosis can also cause dizziness, limb numbness, and pathological reflexes. The differentiation should be the symptoms of cerebral cortex hypofunction, such as dizziness, memory loss and sleep disorders, and the symptoms are not related to the cervical spine; there are signs of atherosclerosis in the whole body, such as fundus artery, aorta, coronary artery, gastric artery, etc.; the blood ester is increased, and there are constant ischemic changes in cerebral blood flow diagram, and there are no signs and symptoms of cervical spine disease. 5, neurological disorders Neurological disorders have more complaints and fewer signs; mostly symptoms of cortical hypofunction such as headache, dizziness, insomnia, memory loss, etc.; non-episodic and transient; symptoms are closely related to emotional changes; no cervical spine symptoms and x-ray signs. 6.Glaucoma There may be ipsilateral migraine, orbital soreness and nausea and vomiting, and ophthalmologic examination may reveal vision loss, and red vision may also appear. 7. Sympathetic cervical spondylosis The diagnosis of vertebral artery cervical spondylosis and sympathetic cervical spondylosis is controversial, and due to anatomical and physiological pathology, there are many crossover points between vertebral artery cervical spondylosis and sympathetic cervical spondylosis in terms of etiology and clinical manifestations, which makes it difficult to differentiate vertebral artery cervical spondylosis from sympathetic cervical spondylosis in clinical practice. First of all, the clinical manifestations of vertebral artery type focus on the symptoms of vascular compression and insufficient blood supply, while the sympathetic type shows symptoms of sympathetic excitation or inhibition, and patients show complex symptoms of sympathetic reflexes in different segments, such as visual disturbance, tinnitus and nystagmus, reduced muscle strength, and hyperactive tendon reflexes, also known as Barre-Lieou syndrome. This is closely related to the nature and number of postganglionic fibers involved in the reflexes. Atypical angina due to sympathetic cervical spondylosis is one of the specific types. The symptoms of sympathetic cervical spondylosis are not only the manifestations of vertebral artery cervical spondylosis, but also other symptoms of sympathetic nerve dysfunction, i.e. sympathetic excitation or inhibition, such as headache, dizziness, tachycardia, cold limbs, etc., or bradycardia, low blood pressure, enhanced gastrointestinal motility, lacrimation, nasal congestion, etc. Nearly one-third of patients have no other symptoms of cervical spondylosis. Secondly, there is no vertebral artery stenosis on angiography of sympathetic cervical spondylosis on ancillary examination to differentiate it from vertebral artery-type spondylosis. It was also found that the results of color Doppler ultrasonography were different in the two types of cervical spondylosis, vertebral artery type cervical spondylosis and sympathetic type cervical spondylosis, in which the resistance index (RI) and pulsatility index (PI) were higher in vertebral artery type cervical spondylosis than in patients with sympathetic type cervical spondylosis. Finally, in terms of diagnostic treatment tools, vertebral artery type requires vertebral arteriography or MRI vertebral artery visualization, and sympathetic type requires effective further differentiation by cervical high epidural closure or cervical sympathetic nerve closure.