Feeling dizzy is a very common feeling among people. But, have you felt dizzy alongside the sensation or feeling that the world around you is somehow whirling? That is vertigo.
Vertigo is the type of dizziness that brings about the sensation or feeling that you are spinning around your environment or it is spinning around you.
Vertigo is primarily caused by issues with the inner ear or the central nervous system. This makes it categorizable into two main types; central and peripheral vertigo. To help you understand the two, we provide you with crucial details about central vs. peripheral vertigo.
Central vertigo definition
Central vertigo refers to the type of vertigo that emanates due to problems or issues in the brain, cerebellum, or brainstem- the part of the brain that is lowest and located right above one’s spinal cord.
The cerebellum helps with balance coordination, while the brainstem serves as a relay center by connecting the cerebellum to the spinal cord.
Peripheral vertigo definition
Peripheral vertigo refers to the kind of vertigo that results from conditions, problems/issues of the inner ear. The inner ear is made up of the vestibular system, which handles bodily balance.
Peripheral vertigo is more common than central vertigo. One key detail to help distinguish central vs. peripheral vertigo is the duration of attacks. It is primarily acute, severe, and episodic. On the other hand, central vertigo primarily occurs over a long time, but mostly, the symptoms are less severe.
Suggested article: Peripheral Vertigo – Causes, Diagnosis, Symptoms, Treatment
Central vertigo causes
- Vertebrobasilar insufficiency; whereby the arteries that supply blood to the brainstem narrow or have a blood clot.
- Cerebellar vascular lesions; where there exists swellings or malformations within the cerebellum arteries, veins, and lymphatics.
- Acoustic lesions; a disease or an injured area in the brainstem or cerebellum.
- Vestibular migraine; a problem of the nervous system that causes dizziness.
- Brainstem ischemia or stroke; a bleed or blood clot in the brain that stops its blood supply.
- Demyelination syndrome; brain cell dysfunction due to the destruction of the myelin sheath. This is the protective layer covering the pons (nerve fibres within the middle of the brainstem).
- Tumors like a cerebellum brain tumor and acoustic neuroma- a tumor (noncancerous) that occurs on the central nerve originating from the inner ear into the brain.
- Chiari malformation; caused by the extending of brain tissue into the spinal canal.
- Multiple sclerosis; nerve damage due to a neurological disorder.
- High altitude cerebral edema (HACE); swelling of the brain with fluid due to physiological impacts of high altitude travel.
Peripheral vertigo causes
- Benign paroxysmal positional vertigo (BPPV): This is whereby small crystals get loose or move and begin to float or build up in the inner ear’s fluid.
- Meniere’s disease: It results from the dysfunction of the inner ear as a result of too much pressure caused by excessive endolymphatic fluid.
- Vestibular neuronitis/ Labyrinthitis: These two mainly result from an inner ear infection, mainly viral. The infection can be on the vestibular nerve or the labyrinth respectively. With labyrinthitis, one may suffer hearing loss.
- Perilymphatic fistula: results when the fluid of the inner ear leaks into the middle ear due to a sudden pressure change, tear, or head injury.
- Superior semicircular canal dehiscence syndrome (SSCDS): SSCDS may come about due to the breakdown of a bony section of the canal within the inner ear that carries fluids.
Suggested article: Causes of Vertigo in Elderly People – Vertigo and Age
Symptoms
Both conditions may occur alongside nausea and vomiting, walking difficulty, and the loss of balance. Sometimes a feeling of ear fullness and ringing may be experienced.
Head movements may worsen peripheral vertigo. It is also typically associated with unidirectional and fatigable horizontal/rotary nystagmus. Nystagmus refers to quick, jerking, and uncontrolled side-to-side eye movements. Central vertigo may manifest non-fatigable nystagmus in any direction, but mostly multi-directional.
Diagnosis
It is essential that if you suffer any symptoms of vertigo, you seek medical help. That way, the doctor can help you determine the specific type you’ve got. They can also identify the cause and help you with the appropriate method of treatment and management. Tests include;
Balance tests like;
- Romberg’s test: entails closing your eyes and standing with the arms to the side and the feet together. Feeling unsteady or unbalanced may signify a problem with the central nervous system.
- Fukuda-Unterberger’s test: entails marching in place for about thirty seconds with closed eyes. Leaning or rotating to one side may signify a problem with the labyrinth.
Vestibular test battery: a combination of tests that help determine a problem in the inner ear. Goggles are used to monitor one’s eye movement as they follow a particular target. One is also asked to move their head and body after cool and warm water is put in the ear canal.
Head impulse tests: Gently moving the head as one focuses on a stationary target. It helps see how the inner ear’s balance system works in controlling eye movements as the head moves.
Radiographs: CT or MRI scans can be done on the brain or neck.
Treatment options and management
There are treatment and management options for both central and peripheral vertigo. The right treatment recommended is dependent on several factors, such as the root cause and symptom severity. They include;
- Medication aimed at treating your underlying vertigo’s cause and easing symptoms. Mostly, antibiotics, motion sickness/nausea medication, antihistamines, and steroids. (More here – Medications for Vertigo – The Most Commonly Prescribed Drugs)
- Physical therapy and specific guided exercises. For example, the canalith repositioning procedure (CRP), Brandt-Daroff exercises, and the Epley maneuver for those with BPPV and Vestibular rehabilitation. (More here – 4 Exercises for Vertigo – Alleviate Your Vertigo Symptoms Naturally)
- Surgery. It is done whereby your vertigo is caused by a serious underlying life-threatening issue. For example, a neck injury or brain tumor.
Final thoughts
You now have a clear understanding of central vs. peripheral vertigo. They are different. It is essential to know that any kind of vertigo and its related symptoms can be disabling or incapacitating and result in an interrupted life and activities.
If you suffer from vertigo, seeking professional medical advice can help you determine which kind you suffer from. The cause can then be addressed appropriately for a treatment and management plan.
Suggested articles:
– How Long Does Vertigo Last? – Identify The Factors
– Vertigo vs Dizziness – The Difference Between Vertigo and Dizziness
– Is Vertigo Hereditary? – Find Out the Answer
– Can High Cholesterol Cause Dizziness?
– Can Allergies Cause Dizziness? – Causes and Treatment Options
– Dizziness When Lying Down – What are the Causes?
– Vestibular Disorder – Issues of the Vestibular System
