Neurological causes of dizziness
Around one in four people report dizziness at some point in time during their lives. It is the most common reason for people being referred to neurologists (outpatient referrals) and also to emergency neurological consultations. Though in most cases, dizziness or vertigo is a common ENT finding owing to vestibular neuritis and benign paroxysmal positional vertigo (BPPV), neurologists’ assessment is imperative to rule out CNS causes of dizziness. The following are the top 5 neurological causes of vertigo
Neurological Causes of Dizziness – Vestibular Migraine
Migraine-associated vertigo or migraine-associated dizziness is reported in around 10 to 20% of patients having migraine. Therefore, to aptly describe this condition, the term vestibular migraine (VM) is used – owing to a wide range of vestibular symptoms. Vestibular symptoms spontaneously manifest and may last for a few minutes to hours or even up to a few weeks. But, usually, the duration of the symptoms along with migrainous features such as visual aura, migraine headache, phonophobia, and photophobia may last for a few minutes to 72 hours.
Post-concussion Syndrome
In around 30% to 80% of concussed individuals, post-concussion syndrome is reported. The symptoms associated with this condition include sound and light sensitivity, dizziness, problems with visual focus, sleep disturbances, irritability, anxiety, mental fog, and depression. Dizziness may be due to CNS effects of the trauma, vestibular migraine, and neuropsychiatric disorders (anxiety and depression). Post-traumatic benign paroxysmal positional vertigo is also a common finding post-concussion.
Posterior Fossa Stroke
In typical vestibular syndrome dizziness along with nausea, vomiting, and head motion intolerance may typically last for up to 24 hours. The diagnosis of posterior fossa stroke is made if the acute vestibular syndrome is associated with ocular motor palsies or hemiparesis. In an emergency room, proper and accurate evaluation of patients with dizziness is important for a precise diagnosis and treatment. An experienced neurologist properly distinguishes peripheral causes of dizziness from central ones.
Vestibular Neuritis
Vestibular neuritis is a condition in which a viral infection causes damage to the nerves of the inner ear. The signals send to the brain after this may lead to a feeling of dizziness. The other signs and symptoms associated with this condition may include nausea, vomiting, and unsteady walking.
Meniere’s Disease
As with vestibular migraine, in Meniere’s disease also vertigo or dizziness comes in episodes but usually with hearing symptoms. Dizziness can also be a sign of TIA (transient ischemic attack) or pre-stroke. Therefore, people who are experiencing dizziness with blurred vision, confusion, headaches, difficulty understanding others, and problems with balance and coordination should immediately consult a neurologist to rule out stroke. An experienced and expert neurologist will assess your immediate risk for stroke.
Bottom Line
Neurological causes of dizziness: In many cases of vertigo or dizziness, the potential risk of an underlying neurological cause is very much possible. The most common are vestibular migraine – and also – brain stroke – especially posterior fossa stroke requires immediate emergency care. It is associated with the acute vestibular syndrome – which can potentially and significantly increase the risk of life-threatening complications and even death.
In cases reporting any clues pertaining to CNS involvement of vertigo or dizziness – a diligent and thorough neurological examination and evaluation focusing on the vestibular system mostly reveals hints about the underlying causes of vertigo.
