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Is there a hallucination of movement? Vertigo is a false sense of movement [1] that might be spinning, rocking, swaying or bouncing, caused by disorders affecting the vestibular end-organs, their peripheral or central connections. Some vestibular disorders can present with lightheadedness or “brain fog,” but these symptoms could also arise from orthostatic hypotension, anemia, hypoglycemia, thyroid disease, B12 deficiency, anxiety or depression and merit a broader search. If it is vertigo, is this the first presentation? A first attack of acute spontaneous vertigo, lasting about 24 h or longer, merits careful consideration of the common causes of “acute vestibular syndrome” (vestibular neuritis and stroke) whereas recurrent vertigo is more likely to represent an innocuous cause. Episodes of recurrent vertigo increasing in frequency and severity (crescendo vertigo) also merit careful consideration of transient ischemic attacks. Is the vertigo spontaneous or triggered? Can it happen when sitting perfectly still, in the absence of a trigger or is it only brought on by a change in head position: bending down, arching back to instill eye drops or turning over in bed? Spontaneous vertigo occurs at rest and will, of course, worsen with head movement. Positional vertigo that is absent at rest and triggered by head movement is likely to represent benign positional vertigo (BPV). Other vertigo triggers such as a strong perfume or a compelling visual stimulus might point to vestibular migraine (VM), while symptoms brought on by entering a supermarket or crowded public place may represent psychophysiological vertigo. How long does each episode last? Brief spells of vertigo lasting seconds to minutes may represent BPV, VM or vestibular paroxysmia whereas vertigo lasting hours could be VM or Ménière’s disease (MD) [2, 3]. Continuous vertigo lasting days may be encountered in VM, vestibular neuritis or stroke [2–5]. Is there hearing loss, tinnitus or aural fullness? Aural symptoms that are time locked with episodic spontaneous vertigo are commonly encountered in MD [3]. When aural symptoms accompany acute vestibular syndrome, labyrinthine ischemia must be considered [6]. Is there a current, past or a family history of migraine headaches or aura or even motion sensitivity? Some patients may have difficulty recognizing that their “ordinary headaches” which are moderate to severe, sometimes unilateral, throbbing and associated with nausea, photophobia or phonophobia, could represent migraines. Are there non-vestibular neurological symptoms? Speech disturbances, limb weakness, clumsiness and symptoms referable to the remaining cranial nerves could indicate central vertigo. Once a careful history is taken, if the diagnosis is not already apparent, it will at least be narrowed down to one of the following syndromes: episodic positional vertigo, episodic spontaneous vertigo or acute vestibular syndrome (Table 1).