vertigo may be due to central lesions or peripheral lesions. Vertigo may also be psychogenic or occur in conditions which limit neck movement - "nuchal vertigo", for example, due to cervical spondylosis, or following a "whiplash" flexion-extension injury.
it is important to determine whether the patient has a peripheral or central cause of vertigo (1)
details obtained from the history that can be used to make this distinction includes: (1)
the timing and duration of the vertigo
provoking or aggravating factors
associated symptoms such as
pain
nausea
neurologic symptoms
hearing loss
the duration of vertiginous episodes and associated auditory symptoms helps to narrow the differential diagnosis (2)
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