Disorders Causing Central Vertigo

Central vertigo is caused by disorders affecting the cerebellum and the brainstem. It can produce a strikingly different clinical picture from that of peripheral vertigo. The onset is usually gradual, the sensation less intense, and symptoms are not provoked by changes in position. Central vertigo is unlikely to be associated with nausea, vomiting, or diaphoresis. Unlike conditions causing peripheral vertigo, both tinnitus and hearing impairment are unlikely. Nystagmus is more likely to be vertical than horizontal or rotatory and may be present in the absence of vertigo. Oscillopsia is a common finding. Central vertigo tends to be accompanied by other signs of brainstem disease, such as ataxia, blurred vision, long tract signs, dysphagia, dysarthria, and diplopia.

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