Wednesday, February 29, 2012

Peripheral vs Central Vertigo

Distinguishing Characteristics of Peripheral vs. Central Causes of Vertigo

FeaturePeripheral VertigoCentral Vertigo
Nystagmus   Combined horizontal and torsional
No directional change with gaze
Inhibited by eye fixation
Fade after a few days
Purely unidirectional
Directional change with gaze towards fast phase
Not inhibited by eye fixation
May last weeks to months
Imbalance Mild to moderate
Able to walk
Severe imbalance
Unable to stand still or walk
Nausea, vomiting May be severeVaries
Hearing loss, tinnitusCommonRare
Non-auditory symptomsRareCommon
Latency following
provocative test
Long (up to 20 seconds)Short (up to 5 seconds)

Reference:  Initial Evaluation of Vertigo, Jan 15, 2006 American Family Physician

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