ObjectiveDetermine the efficacy and applicability of electronystagmography (ENG) testing in the differential diagnosis between peripheral and central vertigo, through the visual‐vestibular interaction test, in patients with vertigo.MethodPatients were submitted to ENG recording. Patients sat on a rotatory chair, which was placed in the middle of a rotary rotatory cylindrical chamber. The rotatory chamber was driven by a direct current engine, which turned it clockwise and counterclockwise, and its internal area was covered with 32 black vertical contrast.ResultsAll patients underwent rotatory vestibular stimulation by Stop test (VOR), optokinetic stimulation (OKN), and contemporary rotatory vestibular and optokinetic stimulation (VVOR). Our experiences highlight as normal that subjects and/or patients affected by peripheral vertigo present a VVOR nystagmus homodirectional to optokinetic nystagmus; patients affected by central vertigo present a VVOR nystagmus homodirectional to vestibular‐ocular‐reflex (VOR). In healthy patients, VVOR nystagmus is always homodirectional to OKN and indicates the optokinetic system prevalence on VOR.ConclusionThe presence of a VVOR nystagmus homodirectional to VOR indicates the absence of the optokinetic system prevalence due to a central nervous system (CNS) modification, and highlights a CNS disease. Our data highlight the role of ENG in the diagnosis between peripheral and central vertigo.