Patients with complaints of “dizziness” often make an odyssey of visits to physicians belonging to various specialties. The prevalence of vertigo in the population is 17–30%. In most cases, disorders of various areas of the vestibular analyzer form the pathogenetic basis of vertigo and unsteadiness, while the most common cause of these complaints is the pathology of the peripheral area of the vestibular system: benign paroxysmal positional vertigo, vestibular neuronitis, Meniere’s disease. The cerebral vessel disease caused by hypertensive cerebral microangiopathy and cerebral atherosclerosis can also manifest by vertigo and unsteadiness. They can be represented by acute cerebrovascular disorders in the vertebrobasilar arterial system, transient ischemic attacks, as well as manifestations of chronic cerebrovascular disease (chronic cerebral ischemia, discirculatory encephalopathy). Episodes of recurrent spontaneous vestibular vertigo can be caused by vestibular migraine, which is rarely diagnosed in our country. The variety of reasons for complaints of vertigo and unsteadiness defines many therapeutic approaches to the treatment of these diseases. In recent times, modern drug and non-drug approaches to the treatment have been developed for patients with various diseases manifested by vertigo and unsteadiness. The most effective treatment is a comprehensive therapeutic approach that combines non-drug therapy, including vestibular gymnastics, training on the stabilographic platform with biofeedback according to the support reaction, and drugs that help reduce the severity, duration, and frequency of vertigo attacks, as well as accelerate vestibular compensation. Many studies have shown the efficacy of drugs enhancing microcirculation used for the prophylactic treatment of various causes of vertigo and unsteadiness.
