Ms. Chen is 55 years old and has felt numbness on the right side of her face in recent times, as if she had been given anesthetic. She had previously gone to a cervical spine film because of dizziness, but no abnormality was found. The doctor told her to put my pillow lower, and there was a slight improvement in her symptoms. Nearly four months Ms. Chen again feel very difficult head and neck, has been dizziness can not be relieved. She is puzzled, in the end, what disease triggers dizziness? What tests should be done? We often see patients with dizziness who are nervous after an attack, fearing that their dizziness is caused by some kind of brain lesion. But when they run to the hospital, the doctor either tells them to see an orthopedic surgeon or an ear, nose and throat surgeon. Doctors point out that dizziness is quite common, accounting for about 30% of the total number of outpatients and inpatients. Dizziness is often manifested as a sudden and objective non-existent sensation of rotation, floating, tumbling or drifting in a certain direction of oneself or external objects. It is a motor hallucination caused by lesions in the vestibular canal, brainstem, cerebellum and other systems, resulting in spatial disorientation and balance disorders in the body. There are four common types of vertigo as follows: 1. Otogenic vertigo: vertigo caused by abnormal vestibular vestibular perception. The main manifestations are episodic vertigo, hearing loss and tinnitus, and severe cases are often accompanied by nausea, vomiting, pallor, sweating and other vagus nerve stimulation phenomena, and nystagmus may occur. Patients often feel the rotation of objects or their own rotation, and may appear to be skewed or tilted when walking, and they are conscious during the attack. 2. Cervical vertigo: Most of them are caused by hypertrophic osteophytes of the cervical spine, resulting in insufficient blood supply to the basilar artery of the brain. The vertigo attack is often related to head and neck rotation, and its nature can be rotational, floating, swaying, or sensations such as lower limb tenderness, unstable standing, ground movement or tilting. These manifestations may occur singly or sequentially, and many patients may experience a combination of these sensations. Some patients experience only dizziness and dizziness. If the patient changes position, the dizziness is more likely to be triggered or intensified; emotional factors, exertion, car ride, walking, etc. can also trigger it, and some patients have unknown causes. 3, cerebellar and brainstem diseases: mostly seen in people of advanced age and people with hypertension, diabetes, hyperlipidemia, long-term heavy smoking and alcoholism. When the symptoms of dizziness appear, it should be highly alert, it may be a sign of cerebrovascular disease, which can cause speech and body movement disorders in mild cases, and can cause coma to endanger the patient’s life in severe cases. 4, phytodynamics: about 10%, manifested as dizziness, blurred vision, tinnitus, nausea, panic, insomnia, dreaminess and other kinds of neurological symptoms. Dizziness and lightheadedness are not true vertigo. There are headache, dizziness, insomnia, memory loss and a series of other symptoms of diminished cortical function. Although there are many complaints, there are no obvious positive signs of the nervous system on meticulous examination, and the onset is not episodic or transient, and the fluctuation of its symptoms is often more closely related to emotional changes. What tests should I check for dizziness? Doctors point out that basic systemic examinations, neurological and otologic examinations are important, and Dix-Hallpike examinations should be routinely performed in patients with vertigo in order to quickly identify the most common causes of vertigo. In patients with peripheral vestibular lesions, attention should be paid to the targeted examination of vestibular function, etc., while in patients with central vestibular lesions, attention should be paid to the relevant imaging examinations. Many studies have demonstrated that MRI, audiometry, and vestibular function tests do not differ significantly between unselected patients with dizziness and age-matched normal subjects, with a positive rate of less than 1%, and therefore various ancillary tests are not recommended for unselected patients with dizziness. The root cause of many incorrect diagnoses is precisely that physicians do not take a good history and perform the necessary clinical examinations, have too little knowledge of the various diseases that require differential diagnosis, and rely excessively on ancillary examinations (e.g., CT/MRI of the head or cervical spine, TCD, etc.) without recognizing their limitations.