眩暈是病人就醫很常見卻難以明確表達的病徵，本個案以眩暈作為初期症狀，因頭痛及步態不穩求診，藉由神經學檢查及眼振型態懷疑中樞病灶，經影像學診斷為前庭神經鞘瘤，隨後才出現耳鳴。筆者藉此個案的診療經驗針對眩暈進行文獻回顧，期望建立簡明的評估流程，協助臨床醫師在廣泛的鑑別診斷中辨識出需緊急診治的病患。

Vertigo is a complaint common among patients but difficult for them to articulate. The article reported a case of a young woman with vertigo for years before developing headache and ataxic gait whose neurological examination and nystagmus type indicated central etiology. Tinnitus developed only after the diagnosis of vestibular schwannoma was made via further image study. In this case report, related previous studies were reviewed; based on the experience acquired from treating the patient, the authors proposed a refined diagnostic process to assist physicians in identifying those who require more aggressive management among vertiginous patients in outpatient settings.