Basic Science and Pathophysiology

The control of balance and awareness of oneself in space is a highly complex process requiring input from, and integration of, sensory information from the eye, joints and the vestibular apparatus of the inner ear (Figs 1-3).

This information is integrated and processed by neurological pathways and connections involving cranial and peripheral nerves, the brain stem and higher brain centres.

Disorders in any of the sensory or integrating components can result in symptoms of dizziness or vertigo, but the disorders can be divided into:

• Central causes (vestibular nucleus and above)
• Peripheral causes

Peripheral causes are the more common of the two.

Learning Bite

Peripheral causes account for about 80% of all vertigo cases.