Background : Vertiginous sense means sensation of rotation. Many patients suffer from vertiginous sense and visit emergency room or clinics. It is important to differentiate the vertigo patients into peripheral type and central type, because central vertigo need urgent treatment. Neuron specific enolase (NSE) is a component of specific brain enzyme and consist of 1.5% of total brain protein and is a useful marker to detect brain injury. We evaluated the significance of NSE in vertiginous patients. Methods : We performed this test in acute vertiginous patients whose attack started within 24 hours. Neurological examination, MRI and vestibular function test were performed. By these results, ten peripheral type vertiginous patients and twelve central type patients were selected. Results : The mean NSE level of control was 6.4±3.4 ng/ml, peripheral type patients was 7.6±2.8 ng/ml and central type was 12.0±3.9 ng/ml. The central type patients group was significantly higher than other group (p<0.05). Conclusion : The Neuron specific enolase (NSE) method to differentiate central vertigo from peripheral one in acute phase.