classification by site of lesion

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  • 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)


Last reviewed 01/2018