Vertigo due to central lesions
- in central vertigo (1)
- the vertigo develops gradually. Exception- acute cerebrovascular events (an acute central vertigo is probably vascular in origin)
- central lesions usually cause neurological symptoms and signs in addition to vertigo
- auditory features tend to be uncommon.
- causes severe imbalance
- nystagmus is purely vertical, horizontal, or torsional and is not inhibited by fixation of eyes onto an object
- latency following provocative diagnostic maneouver is shorter (up to 5 seconds)
- causes may include:
- cerebellopontine angle tumor (1)
- cerebrovascular disease:
- transient ischemic attack
- stroke
- vertebro-basilar insufficiency and thromboembolism:
- lateral medullary syndrome
- subclavian steal syndrome
- basilar migraine
- brain tumour:
- for example an ependymoma or a metastasis in the fourth ventricle
- migraine (1)
- multiple sclerosis (1)
- aura of epileptic attack - especially, in temporal lobe epilepsy
- plaque of demyelination in the pons - multiple sclerosis
- drugs - for example, phenytoin, barbiturates
- syringobulbia
Reference:
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