Central Vertigo Questions & Answers

Updated: Nov 26, 2018
  • Author: Keith A Marill, MD, MS; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Questions & Answers

Overview

What is central vertigo?

What is the role of multiple sclerosis in the pathophysiology of central vertigo?

What is the role of acoustic neuromas in the pathophysiology of central vertigo?

What is the pathophysiology of central vertigo?

What is the role of the vertebrobasilar arterial system in the pathophysiology of central vertigo?

What is the role of arterial occlusion and ischemic infarction in the pathophysiology of central vertigo?

What is the role of trauma in the etiology of central vertigo?

What is the prevalence of central vertigo in the US?

What is the mortality and morbidity in central vertigo?

How does the incidence of central vertigo vary by sex?

Which age groups has the highest incidence of central vertigo?

Presentation

Which clinical history findings are characteristic of central vertigo?

How is peripheral vertigo distinguished from central vertigo?

Which factors increase the risk for central vertigo associated with a cerebrovascular accident (CVA)?

What causes depressed consciousness in patients with central vertigo?

How is nystagmus characterized in patients with central vertigo?

What is the role of the Hallpike (Nylen-Bárány) maneuver in the diagnosis of central vertigo?

What is included in the Drachman dizziness battery for evaluation of central vertigo?

What is the role of the head impulse test in the evaluation of central vertigo?

What does a finding of internuclear ophthalmoplegia suggest in patients with central vertigo?

What does the presence of cranial nerve deficits suggest in patients with central vertigo?

Which neurologic findings are characteristic of central vertigo?

Which cardiac findings are characteristic of with central vertigo?

What are the symptoms of central vertigo due to Ménière disease and acoustic neuroma?

What is the role of positional vertigo in the etiology of central vertigo?

What is the role of cranial nerve deficits in the etiology of central vertigo?

Which symptoms suggest a transient ischemic attack (TIA) etiology of central vertigo?

Which symptoms suggest an acute cerebellar disease etiology of central vertigo?

What is the role of caudal cerebellar infarction to the etiology of central vertigo?

What is the role of cerebrovascular disease in the etiology of central vertigo?

What are risk factors for central vertigo?

Which symptoms suggest a multiple sclerosis etiology of central vertigo?

DDX

What are the differential diagnoses for Central Vertigo?

Workup

What is the role of lab studies in the workup of central vertigo?

What is the role of imaging studies in the workup of central vertigo?

Which cardiac tests are performed in the workup of central vertigo?

Which neurologic tests are performed in the workup of central vertigo?

Treatment

What is the initial emergency department care of central vertigo?

What is the role of thrombolytic therapy in patients with central vertigo?

What is the emergency department care for central vertigo in lethargic patients with altered consciousness?

What is the role of recombinant activated factor VII for the treatment of central vertigo?

Which specialists should be consulted in the treatment of central vertigo?

Medications

How is increased intracranial pressure (ICP) treated in patients with central vertigo?

Which medications in the drug class Corticosteroids are used in the treatment of Central Vertigo?

Which medications in the drug class Diuretics are used in the treatment of Central Vertigo?

Which medications in the drug class Benzodiazepines are used in the treatment of Central Vertigo?

Which medications in the drug class H1- receptor antagonists are used in the treatment of Central Vertigo?

Follow-up

When is inpatient care indicted for central vertigo?

When is transfer indicated in the treatment of central vertigo?

How is central vertigo prevented in patients with transient ischemic attacks (TIAs)?

What is the prognosis of central vertigo?

What is included in patient education about central vertigo?