Vertigo Facts

Signs and symptoms

Vertigo is a sensation of spinning while stationary. It is commonly associated with vomiting or nausea, unsteadiness, and excessive perspiration. Recurrent episodes in those with vertigo is common and they frequently impair the quality of life.

Blurred vision, difficulty speaking, a lowered level of consciousness, and hearing loss may also occur. Central nervous system disorders may lead to permanent symptoms.

Differential diagnosis

Vertigo is classified into either peripheral or central depending on the location of the dysfunction of the vestibular pathway.

Peripheral

Vertigo caused by problems with the inner ear or vestibular system is called “peripheral”, “otologic” or “vestibular”. The most common cause is benign paroxysmal positional vertigo (BPPV) but other causes include Ménière’s disease, superior canal dehiscence syndrome, labyrinthitis and visual vertigo. Any cause of inflammation such as common cold, influenza, and bacterial infections may cause transient vertigo if they involve the inner ear, as may chemical insults (e.g., aminoglycosides) or physical trauma (e.g., skull fractures). Motion sickness is sometimes classified as a cause of peripheral vertigo.

Central

If vertigo arises from the balance centers of the brain, it is usually milder, and has accompanying neurologic deficits, such as slurred speech, double vision or pathologic nystagmus. Brain pathology can cause a sensation of disequilibrium which is an off-balance sensation.

A number of conditions that involve the central nervous system may lead to vertigo including: migraine headaches, lateral medullary syndrome, multiple sclerosis.