The aim of this study is to research the structure of acute vestibular disorders at the stage of the emergency room and to determine the frequency of occurrence of life-threatening conditions. Material and methods. It was made the analysis of acute vestibular disorders at the stage of emergency room of the Neurology department of Clinical Hospital No. 7, City Clinical Hospital No. 18 and stroke center of Interregional Clinical Diagnostic Center in Kazan, Tatarstan Republic, Russian Federation, for the period 20162020. The diagnosis of vestibular disorders was established on the basis of clinical data. There were additional instrumental researches made in doubtful cases. Statistical data processing was made using Microsoft Excel 10.0 program. Results. The study included 106 patients in total with reliably established pathology of the peripheral or central vestibular system. The peripheral or functional nature of vestibular disfunctions were identified in 84% patients. 57% patients had benign paroxysmal positional vertigo. 42% of these patients had repeated benign paroxysmal positional vertigo attack. Vestibular neuronitis and Ramsey Hunt syndrome were detected in 15% patients. Acute cerebrovascular origin was diagnosed in 10% patients (10 ischemic strokes and 1 transient ischemic attack). 1 patient had an ArnoldChiari malformation with the development of occlusive hydrocephalus. So, 12 patients had a life-threatening cause of vestibular pathology, among them only 2 patients had isolated vestibular symptoms. Vestibular migraine was diagnosed in another 5% patients. Conclusions. Life-threatening causes of vestibular pathology account for 11% of all cases. Focal neurological symptoms are the main red flags of systemic vertigo. Benign paroxysmal positional vertigo is detected in 57% of cases of vertigo in the emergency room.

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