Peripheral vs. Central Vertigo – Learn the Difference

Distinguishing if the dizzy patient has Peripheral vs. Central Vertigo is the first step in helping a dizzy patient. This distinction makes all the difference in how they are treated and ultimately indicates the severity of one’s situation.

Peripheral vs. Central Vertigo

Central Dizziness is classified when there are issues with a patient’s brainstem and/or cerebellum.

Peripheral Dizziness is classified when there are issues with the vestibular apparatus and/or vestibular nerve which is located in the inner ear.

The breakdown of vestibular dizziness cases is approximately 90% Peripheral and 10% Central.

Central Dizziness

Some of the conditions associated with Central Dizziness include:

  • Stroke
  • Multiple Sclerosis
  • Brain Tumor

Peripheral Dizziness

The common conditions associated with Peripheral Dizziness include:

  • BPPV (Benign Paroxysmal Positional Vertigo)
  • Meniere’s Disease
  • Labrynthitis
  • Vestibular Neuritis
  • Perilymph Fistula

How We Differentiate The Two

The signs that Central Dizziness might be at play:

  • In the Brainstem: headache, dysarthria, diplopia, focal weakness, or sensory loss in the face or limbs
  • In the Cerebellum: incoordination (limb ataxia with intention tremor and terminal dysmetria on the same side)

The signs that Peripheral Dizziness might be at play:

  • Vertigo — sense of spinning
  • Nystagmus — uncontrollable eye shakiness
  • Tinnitus — ear ringing
  • Ear pain or fullness
  • Sensorineural hearing loss

What To Do Now?

Dizzy patients should consult their Primary Care Physician first, as they’re a great resource for ruling out many of the benign causes of dizziness — dehydration, high blood pressures, among other causes.

The next resource would be a Vestibular Specialist. They’re the most well-equipped to diagnose and treat Peripheral Dizziness. However, they’re also adept at determining when Central Dizziness is a high possibility and can point you in the right direction.

If you or someone you know experiences dizziness and is ready to see a Vestibular Specialist, please give us a call at (310) 954–2207 or schedule an appointment with one of our balance specialists.

The Dizzy & Vertigo Institute specializes in bringing dizzy patients back to an asymptomatic life. We’re located in Los Angeles, California and have options for you if you live in another state.

We look forward to hearing from you!


  1. Bill Sanchez on June 7, 2021 at 10:32 pm

    Does insurance cover the treatments you offer for vertigo

    • Dizzy & Vertigo Institute on June 13, 2021 at 1:44 pm

      We are an out-of-network provider, Bill, so unfortunately we do not accept very many insurance policies. However, it’s best if you call our office at (310) 954-2207 so we can check your specific policy.

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