Vertigo, commonly known as dizziness, is a very common condition that is often seen in otolaryngology or neurology. For people who suffer from vertigo frequently, they are anxious to know the causes of vertigo, the dangers of vertigo and how to treat it. However, vertigo attacks can take very diverse forms, from attacks that occur for a few seconds with a change in position, to sudden attacks after a cold or viral infection, to recurrent attacks during exertion or mood swings, to appearing after trauma or the use of ototoxic drugs. What is vertigo? Myth: Almost all patients confuse vertigo, balance disorder and dizziness, and once they occur, they all attribute it to “dizziness and lightheadedness”, and quite a few of them consult the neurology department as an emergency, not knowing that different symptoms are often caused by different causes, and the treatment is very different. So what is vertigo? Correction: Vertigo is the illusion of movement of oneself or objects in the surroundings that occurs suddenly and without external stimuli, which can be rotation, rising, falling or shaking sensation. Balance disorder refers to the feeling of instability when walking or the feeling of repeatedly falling over. Dizziness and lightheadedness refer to the feeling of discomfort in the head that cannot be clearly expressed, such as dizziness and a sense of confusion. Vertigo is usually caused by inner ear disease, in other words, otogenic, and should be seen in the ENT department. Vertigo can be a single attack (only one attack) or recurrent. Some diseases are accompanied by tinnitus and hearing loss, commonly known as Meniere’s disease, sudden deafness, traumatic vertigo, otosclerosis, chronic suppurative otitis media (cholesteatoma), auditory neuroma, RemsayHunt syndrome (herpes zoster), etc. Other diseases do not have tinnitus and hearing loss, commonly known as benign paroxysmal positional vertigo, vestibular neuronitis, etc. Ototoxic drugs mostly cause balance disorders, sometimes accompanied by tinnitus and hearing loss. In general, balance disorders and dizziness and lightheadedness are mostly caused by neurological disorders, vascular disorders or systemic diseases, such as brainstem disorders, intracranial tumors, intracranial infections, cardiovascular disorders, postural hypotension, hypoglycemia, and thyroid dysfunction. From the above definitions, symptom characteristics and disease classification, it is easy to know that only vertigo is closely related to the ear, and it is important not to rush to the doctor. On the other hand, there are many causes of vertigo, so you should visit a regular hospital, and only correct diagnosis can lead to correct treatment. Second, about the treatment of vertigo: Myth: Once vertigo appears, patients mostly ask for infusion treatment, which is a misconception about the treatment of vertigo. Then how should vertigo be treated? Correction: Because there are many diseases that cause vertigo, the treatment is very complicated, and drug treatment only accounts for a small part of it. For example, benign paroxysmal positional vertigo only requires postural rehabilitation, while vertigo caused by cholesteatoma and auditory neuroma should receive surgical treatment. Among the diseases that cause vertigo, Meniere’s disease is more common, so we will introduce the treatment with this as an example. Oral hormones are effective for Ménière’s disease with mild symptoms. If you are worried that taking hormones may cause side effects, or if you have hypertension, diabetes, or gastroduodenal ulcer and cannot use hormones systemically, you can make a tympanic membrane puncture for intra-dural hormone use. Injections are given twice a week for three weeks. The goal of intra-implantation therapy is to maximize the effect of local medication on the inner ear without causing systemic side effects. If the above treatment does not control the vertigo caused by Ménière’s disease and there is hearing loss, intra-dural administration of gentamicin, a method known as chemical vagotomy, may be used. The injections are given once or twice a week for three to four weeks, but this method carries the risk of causing continued hearing loss. The titration method of administration is now commonly used to control vertigo while preserving hearing.