This chapter focuses on the most frequent vertigo syndromes. Characteristic symptoms of Benign paroxysmal positioning vertigo (BPPV) include brief, in part, severe attacks of rotatory vertigo with and without nausea, which are caused by rapid changes in head If the typical positioning nystagmus can be elicited without any additional central signs and symptoms. Menière's disease is typically a combination of abruptly occurring attacks with vestibular and/or cochlear symptoms, fluctuating, slowly progressive hearing loss and, in the course of time, tinnitus. Vertigo and nausea are reduced by antivertiginous drugs used in other acute disorders of labyrinthine function, for example, dimenhydrinate 100 mg as suppository or benzodiazepine. The differential diagnosis of perilymph fistulas includes the following illnesses: BPPV, positional vertigo of central origin, Menière's disease, vestibular paroxysmia, somatoform phobic postural vertigo, labyrinthine trauma and bilateral vestibulopathy. Differentiating vestibular migraine from transient ischemic attacks, Menière's disease or vestibular paroxysmia can occasionally be difficult.