Diagnosis of vertigo in the absence of permanent tissue damage is still difficult. Since a functional deficit should be associated with a reduction in the blood perfusion, authors performed a cerebral SPET in 23 patients with central vertigo, 10 with peripheral vertigo and 17 normal controls, and compared the results with those obtained by CT, NMR and doppler investigation. Cerebral SPET showed higher specificity and sensitivity than other techniques employed in the investigation of peripheral vertigo. These results demonstrated the usefulness of cerebral SPET in the diagnosis of vertigo, particularly in cases of vascular origin. Furthermore, this technique may be performed in any pathology where tissue damage is associated with a perfusion deficit detectable by SPET investigation.