The aim of this topic is on one hand to pick out the semiological features which can quickly show the way of central nervous system lesions related to the vestibular system and on the other hand to describe these main central vestibular syndromes. A particular attention is carried to central otolithics syndromes which often remain undiagnosed. They induce imbalance, non rotatory vertigo, intolerance to linear acceleration and most often there is no nystagmus on examination. Neurophysiological diagram are restricted to a minimum useful to the clinician.