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Die zugrunde liegenden Erkrankungen sind der Benigne periphere paroxysmale Lagerungsschwindel, Morbus Meni\u00e8re, Vestibularisparoxysmie und das Syndrom der dritten mobilen Fenster. 2. Das akute vestibul\u00e4re Syndrom, bedingt durch eine akute vestibul\u00e4re Tonusdifferenz mit dem Leitsymptom heftiger langdauernder Drehschwindel: die akute unilaterale Vestibulopathie\/Neuritis vestibularis. 3. Persistierender Schwankschwindel und Gangunsicherheit bedingt durch ein bilaterales vestibul\u00e4res Defizit: die bilaterale Vestibulopathie. F\u00fcr alle diese Erkrankungen liegen Diagnosekriterien der B\u00e1r\u00e1ny-Society vor, die gleicherma\u00dfen wichtig sind f\u00fcr die klinische Praxis und f\u00fcr wissenschaftliche Studien. F\u00fcr die Behandlung peripherer vestibul\u00e4rer Syndrome werden in Abh\u00e4ngigkeit von der Ursache 5 Therapieprinzipien eingesetzt: 1. Sorgf\u00e4ltige Aufkl\u00e4rung des Patienten \u00fcber Art und Ursache der Beschwerden und die Therapieeffekte; dies ist auch wichtig f\u00fcr die Compliance des Patienten. 2. Physikalisch-medizinische Behandlung: A) Bogengangspezifische Befreiungsman\u00f6ver: f\u00fcr den posterioren Kanal das S\u00e9montPlus-Man\u00f6ver, das dem S\u00e9mont- und Epley-Man\u00f6ver \u00fcberlegen ist; f\u00fcr den horizontalen Kanal das modifizierte Roll-Man\u00f6ver und f\u00fcr den anterioren Bogengang das modifizierte Yacovino-Man\u00f6ver. B) Balancetraining bei sensorischen Defiziten (hohe Evidenz). 3. Symptomatische oder kausale medikament\u00f6se Behandlung. Hier mangelt es weiterhin an placebokontrollierten Pharmakotherapiestudien, sodass die Evidenzlage niedrig ist und ein hoher klinischer Forschungsbedarf besteht. 4. Operative Ma\u00dfnahmen, z. B. bei dem Syndrom der dritten mobilen Fenster. 5. 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