Probable migrainous vertigo (probable MV) is relative with migrainous vertigo (MV). A central lesion should be impressed if the disease-course changes. An oto-neurologic study is recommended to confirm a dubious image finding. A 28-year-old male presented left tinnitus and hearing block for 7 years. Unfortunately, he has been bothered with probable MV since one year ago. Left tinnitus always exacerbated before each attack. However, about half a year ago, left exacerbated tinnitus and dizziness has persisted for three weeks. Magnetic resonance image/angiogram of brain showed a dubious finding in his left midbrain. Electrony-stagmogram, caloric test and left vestibular evoked myogenic potential showed abnormal waves; in addition, his hearing ability improved after treated with a brain circulatory promoter, so there must be something wrong in his left brainstem. In the following half a year, it was uneventful because a sedative or a hypnotics has been properly used.
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