A 80-year-old man presented with recently aggravated dizziness. He has taken an anti-Parkinson drug before 2 years ago. Left spontaneous down beating nystagmus was observed, also ataxic gait. Brain MRI showed diffuse brain atrophy, otherwise no abnormal finding. Rotation chair test showed decreased gain, phase lead and no asymmetry. Saccadic test showed delayed latency and decreased accuracy. And Calroic test didn't show no canal paresis. Dizziness due to Parkinsonism has been known relatively common, especially in old age. However, it is often difficult to diagnosis a Parkinson disease when old age patient present with dizziness. Hence, we report a case of old aged Parkinsonism patient who presented with acute dizziness in perspective of diagnostic careful point with literature review.