Based upon our clinical observations and the results of repeated control-examinations of 21 patients (head injury, traumatic lesions of the cervical spine, postoperative disorders following surgery of cervical discopathy), the characteristic nystagmus features of this particular vestibular syndrome termed as ‘syncopal vestibular fit syndrome’ may be explained as follows: Four different phases may be distinguished which are regularly observed in all the cases, but showing individual variations of their course of development. The main pathogenetic factor of this syndrome is probably a severe impairment of blood circulation within the vertebral and carotid arteries. Neurological and particularly vestibular findings must be interpreted mainly as the symptoms of an ischemic lesion of the dorsolateral corner of the medulla, whereas pathological alterations of the cervical spine and neuronal factors seem to be of minor importance with respect to the origine of this syndr