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Abstract: Vision, propdoceptive and vestibular apparatus informations are part of a very sophisticated system that maintains the body equilibrium. Disorders anywhere in this system may cause several symptoms and only a precise diagnose allows the best treatment option : to treat the case when ever possible. The patient must be well evaluated in a racional protocol that prevents excessive and unjustified costs. Therefore we present a step - by -step diagnostic approach. Every patient is evaluated in the first three steps. step 1 searchs for cardiovascular abuormadities; step 2 searchs for neurological abnormalities (oto-neuro examination); step 3 evaluates nistagmus without visual inhibition (Frenzel glasses). According to each case the patient is also examined in several of the following steps. Basic complementary exams such as audiological, blood tests, and cervical column X - rays may be done in step 4. Vestibular laboratory evaluations are done in step 5, with procedures such as eletronystagmography, cranio - corpography, and posturography. Special complementary exams may be indicated in step 6, including auditory evoked potentials, CT - scan, MRI and transeranial doppler ultrasonography. Differential diagnose criteria for several disorders are presented along with current treatment options.
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