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Peripheral Objective
Sensation of
moving environ
Central Subjective
Moving of person
Psychogenic Pseudovert
Rotation of person's head
Superior 1
Horizontal
Vestibular Vertigo
2
Posterior
Brainstem Cerebellum
• From injury to the balance centers of the CNS, often from a lesion in
the brainstem or cerebellum.
• Less prominent movement illusion and nausea than peripheral
vertigo.
• Neurologic deficits: slurred speech, double vision and pathologic
nystagmus (vertical/torsional)
Kerber et al, 2009; Jahn et al., 2011
Central Vertigo
Brainstem Cerebellum
Caused by infarctions or hemorrhage, tumors (vestibular schwannoma
or cerebellar tumors, epilepsy, cervical spine disorders (cervical
spondylosis), degenerative ataxia disorders, migraine headaches,
lateral medullary syndrome, Chiari malformation, multiple sclerosis,
parkinsonism, etc
Dopamine:
Norepineph: Histamine is
accelerate
facilitates present only
vestibular
compensation centrally
compensation
Infection inflammation
Glutamate
N Vestibularis excitation
NMDA, AMPA
Recept Activ
Cortical
Calcium ↑ ↑ VERTIGO
Stimulation
Anterior Inferior
Cerebellar Artery
Dimenhydrinate
Transmitting stimuli ↓
The pathophysiology
has not been fully clarified
Volume expansion
of endolympha fluid
Ménière’s Disease
Betahistine
(H3 recept antagon)
Tuberomammillary Nucleus
Seemungal et al., 2015
Infection
Treatment of Vestib Neuritis
Inflammation
Corticosteroid
Glutamate
excitation
Cortical
Stimulation
VERTIGO
Vestibular
Dysfunction
Selective Serotonin
Reuptake Inhibitor (SSRI)