Some time ago, I saw a report on the Internet that vertigo is an “incurable disease” like the flu, but of course, the “incurable disease” here does not mean that it is untreatable like cancer, but that it can be cured without seeing a doctor or taking medicine. In fact, this argument is wrong. The causes of vertigo are complex and there are many types of vertigo, including real vertigo and pseudo vertigo, only a small part of real vertigo can be reduced by compensating vestibular function. In many cases, some vertigo can be recurrent, which can seriously affect the quality of life or even be life-threatening, such as Ménière’s disease; some vertigo is a manifestation of intracerebral tumors or other vascular diseases, such as auditory neuroma or intracranial hemorrhage. Therefore, the cause of vertigo is complex and cannot be underestimated. In my clinical work, I met a patient with cerebellar malignant medulloblastoma who was paralyzed and not treated in time because of repeated vertigo and finally lost the best time for treatment. Chen, 52 years old, usually in good health, rarely even got a cold, and never went to the hospital. 1 year ago, he started to have recurrent vertigo, rotating visual objects, feeling himself rotating when closing his eyes, accompanied by nausea and vomiting, lasting about 10 minutes each time, mostly in the morning when he woke up, with an average of about 10 days, accompanied by “creaking” in his right ear. It is accompanied by a high-pitched, persistent tinnitus in the right ear, and intermittent dizziness. The symptoms gradually worsened, and he could lean to the right when standing upright. I had been taking Chinese medicine for treatment, but I thought it was because I was not well rested, and I had heard from my neighbors that vertigo was not curable and would get better after a while, so I never took it seriously. It was only in the past month that I started to experience numbness in both upper limbs and slurred speech during vertigo attacks. Only then did he start to get nervous and went to our vertigo specialist. He was given a detailed examination for vertigo, and the video nystagmography (VNG) basically ruled out vestibular endpoint disease and considered a central lesion. Then, a cranial magnetic resonance imaging (MRI) was performed, which revealed a 4.5w4.2cm mass occupying the right cerebellar hemisphere, and the bilateral cerebellar tonsils were mildly inferiorly displaced to the level of the inferior border of the foramen magnum, which was considered to be a cerebellar tumor. The surgical pathology confirmed that it was a right cerebellar medulloblastoma, but the tumor was already too large to be treated radically. This shows that vertigo can be a common manifestation of different diseases, and even some of them are the first symptoms of potentially life-threatening diseases. Vertigo is actually a kind of motor hallucination or illusion. Although the patient feels that he or she or the surrounding objects are rotating, it is only a subjective sensation, not a real rotation, and it is an abnormal sensation of rotational movement caused by lesions or dysfunction of balance organs (inner ear, auditory nerve, brainstem and vestibular nucleus in cerebellum and its connection pathways, eyes, etc.), and usually accompanied by loss of balance function. It is caused by spatial disorientation and balance dysfunction of human body, and vertigo in a broad sense includes dizziness and lightheadedness. It can be divided into two categories: true vertigo and pseudovertigo, of which true vertigo refers to the obvious sensation of rotation of external objects or oneself, most often caused by lesions of the vestibular system of the inner ear, such as Meniere’s disease, vestibular neuronitis, auditory neuroma, positional vertigo, cervical vertigo, insufficient blood supply to the vertebral basilar artery, etc.; pseudovertigo is manifested by symptoms of dizziness of varying severity, and patients feel ” It is mostly caused by systemic diseases, such as cardiovascular diseases, cerebrovascular diseases, anemia, uremia, endocrine diseases and neurological disorders. Vertigo involves many disciplines such as otorhinolaryngology, neurology, rehabilitation, internal medicine, ophthalmology, etc. Lesions in the vestibular system, visual system and nerve center can cause similar vertigo manifestations, which can pose a great threat to patients. However, due to the complex etiology, vertigo can be a single manifestation or a concomitant symptom of a certain disease, so the diagnosis is often difficult. But as long as we can find a clear cause and treat the cause, the treatment of vertigo is not terrible. A clear diagnosis is the key to effective treatment, so it is necessary to visit several departments, most of which involve otology. Therefore, developed countries in Europe and America have established vertigo treatment centers mainly in otorhinolaryngology, which integrate vertigo-related departments and are equipped with a complete set of vestibular examinations to greatly improve the diagnosis of vertigo lesions and their nature, and provide corresponding treatment. However, there are still many patients in the society who choose different departments because of different first symptoms, and each department has its own diagnosis and treatment, so there are not many confirmed diagnoses, many misdiagnoses and omissions, and the diagnosis and treatment are not standardized and comprehensive. The Department of Otolaryngology of the Second Affiliated Hospital of Sun Yat-sen University, in conjunction with the Department of Neurology and the Department of Rehabilitation, has established a specialized vertigo clinic, which is moving towards the vertigo treatment centers in Europe and the United States, actively strengthening the cooperation of related departments and establishing a corresponding consultation system to jointly improve the research and treatment of vertigo. The diagnosis rate of Meniere’s disease, auditory neuroma, positional vertigo, cervical vertigo, and insufficient blood supply to the basilar artery has basically reached 100%, and the treatment effect of positional vertigo caused by otoliths, Meniere’s disease, and auditory neuroma is good, and the consultation system with related departments such as neurology and ophthalmology has been started, and the treatment effect of cervical vertigo, insufficient blood supply to the basilar artery, and visual vertigo is also satisfactory. The specialized vertigo clinic adopts a ladder therapy, from prevention, etiology treatment, drug control, physical therapy (low-pressure pulse therapy instrument, etc.), rehabilitation training, functional exercise to surgery, and the targeted treatment of vertigo has reached the domestic advanced level. The unique otolith manipulation reset for positional vertigo caused by otoliths is effective and quickly relieves patients’ symptoms. The newly introduced Meniett low-pressure pulse therapy instrument is an effective treatment method designated for Meniere’s disease by applying low-frequency and low-amplitude pressure pulses to the middle ear to drain lymphatic fluid from the cochlea and reduce the symptoms of Meniere’s disease (commonly known as “ear water imbalance”). The treatment of otogenic vertigo by combining dietary control, medicine and surgery has reached the advanced level at home and abroad. At the same time, we carry out special treatment for the cause of the disease, such as intra-dural drug injection, upper semicircular canal fissure repair, endolymphatic sac decompression, vestibular neurotomy, and inner ear vagus perfusion. Because of the complex causes of vertigo, many non-specialists do not understand it, and patients have misconceptions about it, so it is more likely to be misdiagnosed and mistreated. Finally, I would like to advise that vertigo patients should not be afraid to seek medical advice, but should be diagnosed and treated as early as possible, especially by choosing a vertigo specialist with comprehensive strengths, so as to avoid misdiagnosis and omission, which may lead to misdiagnosis.