Central Vertigo and Dizziness: Epidemiology, Differential Diagnosis, and Common Causes

  title={Central Vertigo and Dizziness: Epidemiology, Differential Diagnosis, and Common Causes},
  author={Mehmet Baran Karataş},
  journal={The Neurologist},
  • M. Karataş
  • Published 1 November 2008
  • Medicine, Psychology
  • The Neurologist
Background:Dizziness is a common complaint among patients seen by primary care physicians, neurologists, and otolaryngologists. The most common causes of dizziness are peripheral vestibular disorders, but central nervous system disorders must be excluded. This article provides an overview of the epidemiology of dizziness, differentiating between central and peripheral vertigo, and central causes of dizziness. Review Summary:Dizziness is among the most common complaints in medicine, affecting… 

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The first question in approaching patients with dizziness is to categorise dizziness into one of the four groups: lightheadedness, pre-syncope, disequilibrium, and vertigo.

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The aim of this review is to provide an update on the main differential diagnoses of dizziness, with particular attention to the different otologic, neurologic and neurologic causes of vertigo, covering epidemiology, pathophysiology, clinical presentation, and therapy.

A Holistic Approach to a Dizzy Patient: A Practical Update

A clinical protocol for approaching a dizzy patient with vertigo is recommended and the epidemiology, pathophysiology, symptoms, diagnosis, and contemporary treatments of all causes of vertigo are presented.

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Information is provided on the differential diagnosis of peripheral vertigo in BPPV, AVN, and Meniere’s disease.

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  • 2009
The distinction between central and peripheral vertigo will be emphasized and the various causes of each type of vertigowill be presented.

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A careful and systematic approach to dizzy patients is the key to making a correct diagnosis and fi nding the optimal treatment and the various causes of each type of vertigo will be presented.

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Better understanding of the various etiologies of various vertigo syndromes, their associations in various age groups and systemic diseases help better treatment outcomes.

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Migraine, cerebrovascular disorders especially involving the vertebrobasilar territory, cardiocirculatory diseases, neurovascular compression of the eighth nerve, and vasculitis are vascular causes of vertigo syndromes.

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Vertigo and dizziness--a clinical approach.

The majority of dizzy patients belong to Types II, III and IV, collectively called the non-vestibular system disorders, and some special bedside tests--the dizziness simulation battery--are often required for properly distinguishing the various types of dizziness.

[Statistical observation of vertigo and dizziness patients].

BPPV was most frequent and diagnosed by typical positioning nystagmus, and other peripheral vestibular disorders, and disorders of other origins should be differentiated from the first screening.

Dizziness and vertigo in vertebrobasilar disease. Part II. Central causes and vertebrobasilar disease.

Central causes of vertigo are less common than peripheral or "systemic" etiologies, the vertiginous symptomatology is usually less prominent, and additional neurological signs are usually present on examination.

How Common Are Various Causes of Dizziness?: A Critical Review

Dizziness is due to vestibular or psychiatric causes in more than 70% of cases, and serious treatable causes appear uncommon, so diagnostic testing can probably be reserved for a small subset of patients.

[Incidence of vertigo and dizziness disorders at a university hospital].

This research and the past 2 reports based on diagnostic criteria prescribed by the Japan Society for Equilibrium Research showed almost the same incidence of vertigo, i.e., BPPV of 30-40%, Meniere's disease of 7-10%, other peripheral vestibular disorders of 15-20%, and central Vestibular disorder of 6-8%.

[Vertigo and pathology of the cerebellospinal system].

The classical classification of the central and peripheral vestibular syndromes has become obsolete and should be abandoned.

Vertigo and Dizziness Related to Migraine: A Diagnostic Challenge

Migrainous vertigo (MV) is a vestibular syndrome caused by migraine and presents with attacks of spontaneous or positional vertigo lasting seconds to days and migrainous symptoms during the attack.

Vertigo as a Symptom of Migraine

Vestibular migraine presents with attacks of spontaneous or positional vertigo lasting seconds to days, and the pathogenesis of VM is uncertain, but migraine mechanisms may interfere with the vestibular system at the labyrinth, brainstem, and cerebral cortex.

Central vestibular disorders

The most important and frequent forms of central vestibular vertigo syndromes, including basilar/vestibular migraine, are provided, which are characterized by ocular motor, postural, and perceptual signs.

Phobic postural vertigo: a new proposed entity.

Patients diagnosed with phobic postural vertigo presented with complaints of unsteadiness with or without dizziness, and attacks of sudden veering that caused them to grasp for support that led to effective treatment.