Causes of Central Vertigo
| Stroke (including brainstem and midline cerebellar cerebrovascular events) |
| Vertebrobasilar or brainstem ischaemia |
| Vertebral artery dissection |
| Migraine (Migrainous vertigo) |
| Space occupying intracranial lesions |
| Focal seizure (temporal or parietal lobe) |
| Multiple sclerosis or demyelinating disorder |
| Chiari malformation |
| Episodic ataxia type two |
Central vertigo arises due to defects of the vestibular nucleus or higher central nervous system connections.
Brainstem vestibular nuclei, the cerebellum and their connections may be affected by a number of pathological processes including:
- Haemorrhage
- Infarction
- Ischaemia
- Demyelination
- Tumour compression
These may result in vertigo. However, when vertigo occurs, it is usually associated with other features of brainstem or cranial nerve dysfunction.
The mechanism by which migraine causes vertigo is not well understood, but it can be associated with migraine headache in susceptible individuals.