Difference between central and peripheral vertigo:
Ans. b (Purely horizontal nystagmus without torsional component is common in central vertigo). (Ref. Harrison's medicAine 16th ed. 132)Differentiation Between Peripheral (Labyrinth) And Central (Brainstem/Cerebellum) Vertigo FeaturesPeripheral vertigoCentral vertigo1Direction of associated nystagmusUnidirectional (fast phase opposite lesion)Bi or unidirectional2Purely horizontal nystagmus without torsional componentUncommonCommon3Vertical or purely torsional nystagmusNever presentMay be present4Visual fixationInhibits nystagmus and vertigoNo inhibition5Severity of vertigoMarkedMild6Direction of spinTowards fast phaseVariable7Direction of fallTowards slow phaseVariable8Duration of symptomsFinite (minutes/ days/ weeks),May be chronic but recurrent9Tinnitus and/deafnessOften presentUsually absent10Associated central abnormalitiesNoneExtremely common11Common causesLabyrinthitis, Meniere's, vestibular neuronitis, Ischemia, trauma, toxinVascular, demyelinating, neoplasms
Nystagmus associated with central vertigo is unidirectional
Purely horizontal nystagmus without torsional component is common in central vertigo
Central is more severe than peripheral vertigo
Tinnitus and deafness are often present in central vertigo
Assessment of Vestibular Function