Old Mrs. Chen suddenly became dizzy and spinning when she was out for a walk, and was afraid to open her eyes to see things, accompanied by nausea and vomiting. Because she had been suffering from hypertension, she thought that her blood pressure had increased and she had a stroke, so she immediately took blood pressure lowering drugs. After examination and examination, the doctor thought that old Mrs. Chen was suffering from vertigo, which is a disease very easy to be committed by the elderly. Through the doctor’s explanation and treatment, old Mrs. Chen went home satisfied. Vertigo is a disorder of the body’s orientation sensation of spatial relations and is a kind of motor hallucination. Patients subjectively feel a sensation of rotation or shaking of themselves or external objects, often accompanied by nausea, vomiting, nystagmus and unsteadiness in standing. The symptoms can be mild or severe, but the patient is always conscious. The incidence of vertigo is about 40%-80%, and there are many kinds of diseases that cause vertigo, which can be divided into two categories: peripheral vertigo and central vertigo according to the location of the lesion. Central vertigo is caused by brain tissue and brain nerve diseases, which accounts for about 30% of vertigo patients. There are many causes of vertigo, including about seven categories: 1. Otogenic: including Meniere’s syndrome, vestibular neuronitis, internal auditory artery occlusion, benign positional vertigo, and motion sickness. The vestibular system is an important balance organ of the human brain and is mainly supplied by the vertebrobasilar artery system, and the arteries supplying the inner ear and the vestibular nucleus are both terminal arteries. The vestibular nucleus is the largest nerve nucleus in the brainstem and is superficially located, making it sensitive to hypoxia and prone to symptoms. Vertigo is usually associated with its involvement. Vestibular neuronitis may be a viral infection, with lesions in the vestibular nerve endings, vestibular neurons, and vestibular nerves. The disease is most common between 30 and 50 years of age, with a sudden onset and a history of fever or infection, mostly caused by mumps, measles and herpes zoster viruses. The most prominent clinical manifestation is vertigo, which increases when the head is turned and reaches its peak in a few hours to a few days. There is usually no tinnitus or deafness. The illness lasts from a few days to 6 weeks and gradually recovers. Other infectious diseases of the brain such as labyrinthitis, arachnoiditis of the pontocerebellar horn, and cerebellar abscess can cause vertigo. The typical symptoms of inner ear lesions are sudden and intense rotational vertigo with tinnitus, fluctuating or progressive hearing loss or deafness. There is a feeling of swelling and pressure in the affected ear, accompanied by autonomic symptoms such as nausea, vomiting, pallor, cold sweat, and decreased blood pressure. During the attack period, there is a short period of regular horizontal nystagmus, which starts to fast-phase to the affected side as a stimulation symptom and fast-phase to the healthy side after a few hours as a destruction symptom. The duration of vertigo is short, lasting for a few minutes or hours and relieving on its own, but there are also cases that last for several days. The attacks are often recurrent, and the hearing damage increases with the number of attacks, until the vertigo attacks stop when the deafness is complete. In motion sickness, vestibular dysfunction is caused by the stimulation of the inner ear vestibule during airplane and ship travel, which is manifested as vertigo, accompanied by autonomic symptoms such as nausea, vomiting, pallor, sweating, etc., without nystagmus. 2. Cerebral origin: including vertebrobasilar artery insufficiency of blood supply, cerebellopontine lesions, and vegetative nerve disorders. Most of them are age-related. After the age of 50, the cervical spine is prone to degenerative changes and bone redundancy formation, and the arteries are prone to atherosclerosis, with gradual narrowing of the lumen leading to reduced blood flow. It occurs as a result of affecting the balance function related to the brainstem and cerebellum. Vertigo caused by phytodysfunction is more common in women and is often triggered by poor mood, mental stress and overwork. The clinical manifestation is subjective vertigo, which is episodic in nature and can last from several hours to several days. It has more neurological symptoms and complaints without organic signs of the nervous system, or it can be found that the tendon reflexes of the limbs are symmetrically active and the extremities are wet and cold, and it can be accompanied by autonomic symptoms such as nausea, vomiting, sweating and pallor. 3, systemic: hypertension, hypotension, anemia, metabolic diseases, etc. 4.Cervical origin: the cause may be degenerative changes of cervical spine, cervical muscle and cervical soft tissue lesions, cervical tumor and skull base malformation causing ischemia due to compression of vertebral artery, resulting in vertigo; the main clinical manifestation is various forms of vertigo, the occurrence of which is obviously related to sudden head rotation, often accompanied by nausea, vomiting, ataxia, etc.; 5.Ocular origin: it often appears after using eyesight for too long or gazing for a longer period of time, covering The vertigo can disappear after covering the affected eye or resting with the eyes closed. It can be caused by refractive error, eye muscle paralysis, and vision loss. 6.Drug-related: The application of drugs such as chain, gentamicin, kana or vancomycin, quinine, salicylic acid and phenytoin sodium causes toxic damage to the 8th pair of cranial nerves, which mostly involves the cochlea and vestibular nerve at the same time. The vertigo caused by drug poisoning is mostly progressive and persistent, usually not intense, and often accompanied by balance disorders, tinnitus and hearing loss. The main factor for the occurrence of inner ear poisoning is the susceptibility of the individual, and it is also related to the dose and the duration of drug use. 7. Psychogenic: insomnia, depression, etc. In addition, vertigo can be an important symptom or even the first symptom of multiple sclerosis. The vertigo is episodic and can last for several days at a time, and can be repeated, accompanied by obvious nystagmus, which can still exist after the vertigo disappears. Damage to the vestibular nucleus in the medullary cavity can cause vertigo, but to a lesser extent, with a slowly progressive course. It can be accompanied by trigeminal nucleus sensory disturbance, tongue muscle atrophy and paralysis of the soft palate and vocal cords. Epileptic vertigo is a special kind of vertigo with sudden onset and stop, very brief, with epileptiform discharges on EEG and effective treatment with antiepileptic drugs. Vertigo occurring in the elderly is most commonly associated with inadequate blood supply to the vertebrobasilar artery. These seizures may seem vicious, but they are usually not life-threatening and most recover within a few minutes. Some are accompanied by tinnitus or hearing loss, suggesting the presence of inadequate blood supply to the internal auditory artery, a branch of the basilar artery, at which point it should be distinguished from Meniere’s disease; it can also present with dysarthria, ataxia, and limb numbness and weakness. It is different from dizziness due to acute cerebral infarction, which can sometimes be a dangerous sign and should be treated promptly. What should I do after dizziness occurs? As a patient, you should first acquire some basic medical knowledge. During an acute attack of dizziness, adopting a lying position, avoiding head movement and keeping quiet may help to relieve the symptoms in a short time. Reassure the patient not to be nervous and eliminate the fear. You can also give the patient some sedatives, antiemetic drugs, etc. If the dizziness is persistent, the patient should be actively sent to a specialist hospital for further examination and treatment. Choose neurology first, and then seek assistance from other specialties as needed. Because of its complex etiology and recurrent attacks, vertigo should be treated and medicated differently in clinical treatment.