What is Central Vertigo?

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Introduction

Central vertigo is a type of dizziness caused by problems within the brain. Specifically, central vertigo usually results from problems at the cerebellum (which controls balance and coordination), brainstem (which connects the brain to the spinal cord), or higher cortical centers of the brain.

Central vertigo is complex, may come with other neurological symptoms, and usually results in vertigo that is constant. It can be exacerbated by positional changes, but is usually present even when you are still.

Common Causes of Central Vertigo

Central vertigo can be caused by several conditions:

• Stroke or Transient Ischemic Attack (TIA)

• Multiple Sclerosis (MS)

• Parkinson’s Disease

• Brain tumors (rare)

• Migraine-related vertigo (Vestibular Migraine)

• Head injuries including concussion and TBI

• Infections or inflammation affecting the brain

• Autoimmune pathology

Symptoms of Central Vertigo

People with central vertigo may experience:

• A spinning or tilting sensation that is constant

• Imbalance or difficulty walking in a straight line (feeling like the room is tilting or moving)

• Double vision or and a lack of depth perception

• Coordination impairment and motor weakness

• Slurred speech

• Headaches and migraines

Diagnosis

A doctor or neurologist may recommend:

• A neurological exam to check balance, coordination, eye movements, and reflexes

• Imaging tests (MRI or CT scan) to look for changes in the brain

• Blood tests or other evaluations depending on suspected cause

Treatment Options

The treatment for central vertigo depends on the underlying condition:

• Central vertigo is often treated by a team of medical professionals which often includes: a Neurologist, a Neuro-opthalmologist, a Physical Therapist specializing in vestibular disorders, and a Speech Therapist.

  • Neurologist:

    • often prescribe medication to control nausea, dizziness, or migraines/headaches as needed

    • order imaging of the brain and spinal cord for proper diagnosis and medical management

  • Neuro-ophthalmologist:

    • perform an eye exam that assesses eye movement (different from a typical eye exam)

    • can prescribe lenses for an impairment with convergence, divergence, and oscillopsia that help with depth perception and a tilting or moving world

  • Vestibular Rehabilitation Physical Therapist:

    • prescribes exercises to retrain the brain, improve eye movement, improve balance, decrease dizziness, and improve coordination and motor control

    • help manage headaches, migraines, and vestibular migraines

  • Speech/Cognitive Therapist:

    • help to regain normal speech for individuals that have slurred speech post brain injury

    • help individuals with cognitive impairment improve executive brain function (planning and coping strategies to help individuals accomplish tasks throughout the day without overstimulating the brain)