Peripheral vs. Central Vertigo – Learn the Difference

  • By Dizzy & Vertigo Institute
  • May 31, 2021
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

The balance system is a complex system composed of many parts that send signals to the brain in order to determine how we maintain our balance. Our eyes, muscles and joints, inner ear, and brainstem all play a role in the process of creating balance. The part of the system that is dysfunctioning informs us whether a dizzy patient has 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

Although all cases of dizziness need to be addressed, any indication that there’s Central Dizziness at play need to be taken particularly seriously. This is because the brainstem and cerebellum control many vital health processes. And if those areas are affected then we might be looking at critical problems. Some of the conditions associated with Central Dizziness include:
  • Stroke
  • Multiple Sclerosis
  • Brain Tumor

Peripheral Dizziness

Peripheral Dizziness is a problem with your inner ear that causes a lot of sensation of 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

Vestibular Audiologists, such as our practice at the Dizzy & Vertigo Institute, always start by having in-depth conversations with dizzy patients. During our conversations, we’re listening for certain indicators from patients to point us toward a possible diagnosis. Furthermore, we’re determining what tests we need to run in order to rule out (or in) a diagnosis. 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?

It’s important that dizzy patients refrain from trying to diagnose themselves. There are many overlapping symptoms between Peripheral vs. Central Vertigo. And if you’re playing Dr. Google, it’s far too easy to think you have a problem that you don’t. 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!
    • 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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