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What symptoms distinguish central from peripheral vertigo
What signs and symptoms help distinguish central from peripheral vertigo
Central versus Peripheral Vertigo
| Signs and Symptoms | Central Vertigo | Peripheral Vertigo |
|---|---|---|
| Nystagmus | Often vertical or rotatory, may change with direction of gaze, increase with looking toward side of lesion | Mostly horizontal or sometimes rotatory; unidirectional and conjugate; increases with looking away from side of lesion |
| Latency of onset and duration of nystagmus | No latency after head motion; persistent and lasts >60 seconds | Latency after head motion; fatigable and lasts <60 seconds |
| Caloric test | May be normal | Abnormal on side of lesion |
| Brain stem or cranial nerve signs | Often present | Absent |
| Hearing loss, tinnitus | Absent | Often present |
| Nausea and vomiting | Usually absent | Usually present |
| Vertigo | Usually mild | Severe, often rotational |
| Falling | Often falls toward side of lesion | Often falls to side opposite nystagmus |
| Visual fixation or eye closing | No change or increase of symptoms | Inhibits nystagmus and vertigo |
