The acute and isolated vertiginous symptoms, heterogeneous in their presentation, are a frequent reason for consultation in the emergency room and are a source of diagnostic errors.

Three main aetiologies are involved: positional vertigo, vestibular neuritis and more rarely posterior fossa stroke.

A well-conducted clinical examination, including the nystagmoscopic examination, the head impulse test and the cover test has high diagnostic sensitivity. The diffusion sequence MRI is essential, but its sensitivity remains low in the first hours, especially in small infarcts.