Stable unilateral vestibular deficit (vestibular neuronitis being the most common example in clinical practice) causes an imbalance in the information reaching the two vestibular nuclei at the level of the brain stem. This inequality of information arriving from the inner ear or the vestibular nerve is interpreted by the central vestibular structures as a rotation towards the ear from which it receives more information, generating the natural balancing reactions – nystagmus and vertigo, postural and walking imbalance. The physiological mechanism involved in the healing of such an injury is represented by the phenomenon of central vestibular compensation, an expression of the plasticity of the central vestibular structures. This natural recovery pattern begins in the first days after the acute injury and is a long-lasting process that allows good but incomplete recovery of dynamic deficits secondary to peripheral vestibular injury. This therapeutic window of the first week after onset should not be missed – initiation of pharmacological treatment (betahistine) from the first days and vestibular rehabilitation programs, both of which have been shown to facilitate and accelerate central vestibular compensation and ensuring maximum patient’s recovery.