What are the two classifications of vertigo?

What are the two classifications of vertigo?

• A. CNS or peripheral
• B. Central and sensory
• C. Neural and vascular
• D. Neurological and vestibular

Answer: (A)

Vertigo is categorized by where the abnormal signal comes from: the central nervous system versus the peripheral vestibular system. Central vertigo originates in the brainstem or cerebellum, while peripheral vertigo arises from the inner ear or vestibular nerve. This distinction is the most clinically useful because it points to the likely cause and guides the workup and management. Peripheral vertigo often has abrupt onset and may be accompanied by hearing symptoms; exam findings typically show a horizontal, unidirectional nystagmus that fatigues, with a positive head impulse test. Central vertigo, in contrast, can have vertical or bidirectional nystagmus and is more likely to be associated with other neurological signs such as diplopia, limb ataxia, or dysarthria. Recognizing whether vertigo is central or peripheral helps prioritize urgent imaging and targeted therapy.

Vertigo is categorized by where the abnormal signal comes from: the central nervous system versus the peripheral vestibular system. Central vertigo originates in the brainstem or cerebellum, while peripheral vertigo arises from the inner ear or vestibular nerve. This distinction is the most clinically useful because it points to the likely cause and guides the workup and management. Peripheral vertigo often has abrupt onset and may be accompanied by hearing symptoms; exam findings typically show a horizontal, unidirectional nystagmus that fatigues, with a positive head impulse test. Central vertigo, in contrast, can have vertical or bidirectional nystagmus and is more likely to be associated with other neurological signs such as diplopia, limb ataxia, or dysarthria. Recognizing whether vertigo is central or peripheral helps prioritize urgent imaging and targeted therapy.