Background: Dizziness refers to various abnormal sensations relating to perception of the body’s relationship to space. Vertigo is the most frequent classification associated with dizziness. It is generally defined as the sensation of motion when still or a perception of distorted motion with normal head movement. In each ear, the vestibular nerve connects directly to the ipsilateral vestibular nuclei (VN), as well as to the contralateral side through several interconnecting neurons. The cerebellum, the reticular formation, the spinal cord, and the cervical junction all provide additional afferent information to the VN. Efferent information is relayed from the VN back to these same areas. Central vestibular disorders (CVDs) are group of disorders that are caused by lesions along the vestibular pathways, which extend from the VN in the medulla oblongata to the ocular motor nuclei and integration centers in the pons and rostral midbrain; and to the vestibulocerebellum, the thalamus, and multisensory vestibular cortex areas in the temporoparietal cortex. Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptive and compensatory mechanisms already existing in the human brain. VRT speeds up the process of improvement. Among patients with CVDs, cerebellar dysfunction improves the least after VRT, while others improve significantly, although most continue to exhibit gait dysfunction and continue to be at risk of falling. In central dizziness, postural instability may improve slowly or not improve with VRT. Furthermore, in some degenerative cases, it may progress even with vigorous rehabilitation treatments. Mechanistically, several areas along the peripheral and central vestibular neural pathways may be involved in the pathogenesis of MS. These regions include the eighth nerve, VN, the oculomotor tracts, the medial longitudinal fasciculus, and the cerebellum. Interventions specifically designed to improve balance in MS should yield better results than interventions to strengthen lower limbs or aerobic exercises