We often encounter people around us who are “dizzy”, “lightheaded” or “faint”, and the term “vertigo” is not new to us. The term “vertigo” is not new to you. What is the problem with vertigo? Which department should I see? How do you tell your doctor that you have vertigo? Can vertigo be cured? Vertigo is a symptom with a cause behind it Many patients who come to us for help are confused as to what vertigo is. Is vertigo just a bad dizziness? In fact, there is a fundamental difference between vertigo and dizziness, as dizziness is a feeling of lightheadedness when a patient has an attack. For example, the feeling in the head of a patient with hypertension at the onset of the disease, the feeling of dizziness caused by lack of sleep, cold and fever, and excessive alcohol consumption, etc. should be called dizziness. And those who suddenly stand after squatting or sitting for a long time and feel black-eyed, starry-eyed, unsteady standing or some cause of temporary loss of consciousness, sudden sudden collapse, etc., belong to syncope. Both dizziness and syncope are caused by various diseases related to the central nervous system and are essentially different from inner ear vertigo. When the onset of vertigo is severe, the patient’s eyes are tightly closed and hands are clutching the edge of the bed for fear of falling off the bed, accompanied by nausea and vomiting, abdominal pain and diarrhea, pale face and cold sweat. Although the vertigo symptoms are serious, the patient is conscious. In fact, vertigo is a symptom, just like coughing, sneezing and headache is a symptom, not the name of a disease. But one important point is that the reason why vertigo strikes, it must be caused by some underlying disease behind it. There are many diseases that cause vertigo, and when it is not clear what causes it, we call it vertigo collectively. One-third of vertigo is caused by otoliths. In the inner ear, there is a set of delicate structures that are responsible for the body’s balance and position sensory functions, and if there is a problem in any of these structures, it will cause abnormal balance and position sensory, and vertigo will follow. The cause of benign paroxysmal positional vertigo is that the otolith, which is responsible for balance in the inner ear, is dislodged due to some factors (e.g. internal metabolism, trauma, etc.) and the free otolith enters the semicircular canal, where it is not supposed to go, thus changing the fluid mechanics of the semicircular canal. This changes the hydrodynamic properties of the semicircular canal, resulting in abnormal sensation of head rotation. In other words, when the head moves to a certain position, there is transient vertigo and nystagmus, accompanied by nausea and vomiting. Many people think that vertigo is a minor problem that can be overcome after a while. However, vertigo can be life-threatening, especially when it is caused by neurological diseases, because it can be a precursor of stroke. Especially, middle-aged and elderly people have more or less cervical spine disease, which, together with arteriosclerosis, can easily cause brainstem and cerebellum ischemia or even infarction, thus leading to vertigo. Therefore, it is recommended that middle-aged and elderly people who experience vertigo should first choose to see a neurologist. After central lesions are ruled out, vestibular peripheral vertigo can be considered, at which time vestibular function examination should be promptly performed in otolaryngology. If it is otogenic vertigo, it is not paralyzed, much less life-threatening, and a large proportion of patients with benign paroxysmal positional vertigo can be healed quickly by resetting. If cervical spondylosis is suspected, further diagnosis should be made in orthopedics. Can vertigo be cured? In order to stay away from vertigo, the cause of vertigo should be clarified first. Benign paroxysmal positional vertigo (otoliths) has a high incidence, and its treatment is otolith reset, and most patients can be cured after 1-2 resets. The incidence of migraine-related vertigo is second only to otoliths. The pathogenesis of migrainous vertigo is still unclear clinically, but there are corresponding diagnostic criteria, and the vertigo can be significantly relieved by preventive treatment of migraine, giving the patient appropriate medication along with vestibular rehabilitation exercises and possibly also by relieving the patient’s negative emotions. Meniere’s disease is a disease caused by fluid accumulation in the vagus of the inner ear membrane, with episodes of vertigo, fluctuating deafness, tinnitus and a feeling of fullness in the ear as the main symptoms. During episodes, bed rest and sleep are required, and treatment with diuretics and betahistine is required. During the interval, vertigo disappears and deafness and tinnitus are reduced. The usual low-salt diet, abstaining from coffee, smoking and alcohol, and adjusting emotional psychotherapy. In contrast, vertigo attacks accompanied by sudden hearing loss must be started by improving the blood supply to the inner ear, and improvement of vertigo is often better than improvement of hearing. Vestibular neuritis is an acute onset, spontaneous peripheral vertigo that may be accompanied by nystagmus, nausea, vomiting and balance disorders, but without cochlear or central nervous system symptoms. The vertigo lasts for a long time, days, weeks, or months. The vestibular function on the affected side decreases, and recurrence is rare after healing. The acute phase is treated with adequate hormones and symptomatic treatment, and early vestibular rehabilitation is required to establish central compensation through exercise. In addition, there are 20% of central vertigo such as transient ischemic attack, cerebral infarction, degenerative lesions of the central system, and vertigo caused by hypertension, hypotension, anemia, cervical spondylosis, diabetes mellitus and even visual impairment, which must be actively treated for the original disease in order to solve the vertigo symptoms. Regardless of whether it is otogenic vertigo or non-otogenic vertigo, Chinese herbal medicine can be used to identify and treat the symptoms and even achieve a cure.