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Vertigo of Central Origin
Central Nervous System Origin Vertigo

Presentation

Pathophysiology Any lesion affecting the central vestibular apparatus will present with vertigo as the main presenting symptom. [ncbi.nlm.nih.gov]

Gastrointestinal

  • Nausea

    These patients present with acute onset of extremely severe vertigo with nausea and vomiting. They have prominent peripheral unidirectional nystagmus. Benign paroxysmal positional vertigo is a common cause of peripheral vertigo. [ncbi.nlm.nih.gov]

Ears

  • Tinnitus

    Meniere disease classically presents with recurrent vertigo with tinnitus and low-frequency hearing impairment easily documented with audiometry. [ncbi.nlm.nih.gov]

    In labyrinthitis and Meniere's disease, you may have hearing loss and tinnitus (ringing of the ears) in one or both ears along with the vertigo. There are some common features of peripheral vertigo that can help your doctor make a diagnosis. [webmd.com]

  • Hearing Impairment

    Meniere disease classically presents with recurrent vertigo with tinnitus and low-frequency hearing impairment easily documented with audiometry. [ncbi.nlm.nih.gov]

Neurologic

  • Vertigo

    It is very important to distinguish central vertigo from peripheral vertigo. It is extremely beneficial to approach vertigo in a systematic way. [ncbi.nlm.nih.gov]

  • Nystagmus

    On the other hand, the nystagmus in central vertigo will more commonly present with direction changing nystagmus. The nystagmus will be right beating when the patient looks to the right and change to left beating when the patient looks to the left. [ncbi.nlm.nih.gov]

Treatment

There are drugs and other treatments for both types. Finding out which one you've got -- and what's causing it -- can help you and your doctor decide how to manage it. [webmd.com]

Once a diagnosis of central vertigo has been established, treatment is aimed at the underlying cause. [ncbi.nlm.nih.gov]

Prognosis

Prognosis The prognosis of central vertigo depends on the underlying cause. The most common is acute lateral medullary syndrome due to occlusion of the vertebral artery or the posterior inferior cerebellar artery. [ncbi.nlm.nih.gov]

Etiology

Etiology Central vertigo occurs when there is any lesion or dysfunction of the brainstem vestibular apparatus as described above. [ncbi.nlm.nih.gov]

Epidemiology

Other less common causes include infection, trauma, posterior fossa brain tumors, and migraine.[2] Epidemiology In the United States, approximately 800,000 individuals per year experience a stroke. Of these, about 85% are ischemic. [ncbi.nlm.nih.gov]

Pathophysiology

Pathophysiology Any lesion affecting the central vestibular apparatus will present with vertigo as the main presenting symptom. [ncbi.nlm.nih.gov]

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