▪	Background : Vertigo is defined as a pathologic illusion of movement. Vertigo is one of the complaints that obliges the individuals to presents in ED. In the majority of cases the patients use overlapping terms to describe their experience and even change their minds during a single clinical encounter. Most commonly experienced as a spinning sensation, it arises from a pathologic imbalance in the peripheral or central vestibular system. For clinician is very important to differentiate the peripheral vertiginous syndrome from central vertiginous syndrome and cerebellar infarct too.  10% of patients with cerebellar infarction can present with isolated vertigo. A misdiagnosis rate estimated at 35% and varied in different studies.
▪	Aim: to evaluate the clinical and diagnostic profile of vertiginous syndromes in ED
▪	Methodology : we include in our study 119 patients  (79 F and 40 M0 of age 25-65 y.o., who was present in ED of UHC “Mother Teresa”, Albania from 1 June – 1 Oct 2016 with main complain vertigo.  All of them, underwent a detailed neurologic examination, biochemical blood exams, CT of brain. The clinical examination and neurologic objective examination was repeated approximately every 8 hours for 3 days; and all of them underwent MRI T1, T2, sequences and DWI approximately in a week.
▪	Results : 26 patients (21,8%) presented  with brief episodes of intense vertigo, precipitated by a change in position. The paroxysms of intense symptoms lasting less than a minute. Dix-Hallpike test provokes the characteristic torsional and vertical nystagmus. They was diagnosed with Benign Paroxysmal Positional Vertigo.  
▪	22 patients (18,4%) presented simultaneous vertigo, ipsilateral hearing loss, tinnitus, or aural fullness. Episodes commonly last a few hours, although they can range from 20 minutes to a few days. They was diagnosed with Menier`s disease. 
▪	11 patients (9,2 %) presented recurrent episodes of vertigo that lasts for a few minutes. A formal migraine diagnosis by(I.H.S.) criteria was made during the clinical interview, including here a migraine symptom during the attack (e.g. headache, photophobia, or aura). They was diagnosed with migrainous vertigo.
▪	 18 patients (15,1%)  presented with gradual onset of acute vestibular syndrome, caused by decreased vestibular tone on one side. The patient experiences the world as if they were continually turning their head away from the affected side. They was diagnosed with vestibular neuritis.
▪	 and 21 patients (17,6%) presented severe ataxia with the inability to walk without support, and direction-changing nystagmus. The patients have nystagmus that changes directions according to the patient’s gaze. (if the patient looks to the right it beats to the right, and when the patient looks left it beats to the left). They was diagnosed with cerebellar stroke (ischemic or hemorrhagic stroke).
▪	Conclusion
From this study, we conclude that clinical signs are very suggestive and very imported too, for clinical diagnosis in vertiginous syndrome in ED, in terms when the sensitivity of CT in ED for differentiate these pathologies is 26%.

THE CLINICAL AND DIAGNOSTIC PROFILE OF VERTIGINOUS SYNDROMES IN EMERGENCY DEPARTMENT