Vertigo

Vertigo can be a vexing problem, but a basic understanding of vestibular physiology, coupled with a knowledge of common vestibular syndromes, will lead to correct diagnosis and treatment in most cases. Vertigo is a hallucination of motion, and is the cardinal symptom of vestibular system disease. It should be differentiated by history from other causes of dizziness: imbalance, disequilibrium, and light-headedness (presyncope). The clinical pattern of vertigo is very important for the diagnosis of vestibular system disease, and duration is the most important clinical feature in the diagnosis. Vertigo can arise from the labyrinth (peripheral nervous) system or from the vestibular (central nervous) system. Common peripheral causes of vertigo include vestibular neuritis (sudden, unilateral vestibular loss), Ménière’s disease (episodic vertigo), benign paroxysmal positional vertigo (BPPV), and bilateral vestibular loss. Common central causes of vertigo include vestibular migraine, cerebrovascular disease, and acoustic neuroma.