Central vertigo causes
Vertigo is a sense or feeling of motion or spinning of surroundings. The experience is just like hallucinations of motion. Central vertigo originates from the central nervous system (neurological) vertigo. Multiple Sclerosis, brain infections (meningitis), tumors of the central nervous system (CNS), injury, and trauma to the brain are the other causes of central vertigo. Ischemic and hemorrhagic stroke can also cause central vertigo. Head and neck trauma causes traumatic central vertigo. The complications of this condition include dizziness and vertigo. One of the prominent causes of central vertigo is ischemic brain stroke and the next cause is multiple Sclerosis and acoustic neuroma.
Who are at risk?
The risk of cerebellar-related central vertigo is high among men compared to women as the incidences of ischemic strokes are high in men. The risk further increases with age. High cholesterol levels (hyperlipidemia), cigarette smoking and diabetes mellitus are the other important risk factors.
How to Know that a patient has Central Vertigo?
A neurologist first tries to understand the nature of the patient’s condition to understand the type of dizziness or vertigo the patient is experiencing and also the associated symptoms.
The first major clue is this – in the case of neurological vertigo, in addition to dizziness or vertigo, patients complain about other conditions or symptoms as well.
In general, the conditions that cause central vertigo, cause other symptoms as well.
Central Vertigo Causes
The onset of central vertigo is gradual. Though it is less intense compared to peripheral vertigo, severe complications can involve. A neurologist tries to ascertain the possibility of central vertigo based on these risk factors: a previous history of cerebrovascular accident (CVA), atrial fibrillation, hypertension, and advancing age.
The cerebrovascular disease of the posterior circulation includes Basilar artery occlusion and Vertebral artery occlusion.
What are the symptoms of Central vertigo?
Vertigo implies an abnormal sensation of movement or rotation of the patient or his or her environment. Some patients with the central disease may complain of disequilibrium, imbalance (loss of balance), difficulty maintaining an upright posture; difficulty walking and standing.
In almost 70% of the cases of cerebral hemorrhage or cerebellar infarction, the above symptoms are present. Speech difficulty and occipital headache are the other common symptoms associated with cerebellar disease.
Central Vertigo Differential Diagnosis
If a patient complains of any other associated symptoms apart from dizziness (spinning) or vertigo sensations, then the neurologist may get a clue about the nature of the underlying cause of VERTIGO.
Dix-Hallpike test for Vertigo
The test helps in distinguishing central vertigo from peripheral vertigo.
Dix-Hallpike Test Procedure
During the test, a neurologist rotates the patient’s head 45 degrees to one side. The doctor then instructs the patient to lie down on their back immediately.
Dix-Hallpike Test is Negative
This test is considered positive for benign positional vertigo if the patient experience spinning sensations (rotational nystagmus) when the doctor turns the patient’s head 45 degrees to one side and allow the patient to lie on their back quickly. In this case, the test is negative for central vertigo.
Dix-Hallpike Test Positive
This test is considered a positive test for central vertigo with the involvement of the central nervous system (CNS) if the Dix-Hallpike test is negative for benign positional vertigo.
Dix-Hallpike Test Interpretation
This test is a very useful test to differentiate between peripheral and central vertigo.