What is Central Vertigo?

Central vertigo is dizziness that occurs due to brain diseases.
Forms of central vertigo, medulla oblongata, the vestibular nuclei, the nucleus and the central ocular motor integration centers in the brain, vestibuloserebellum, thalamus and Cortex, temporoparietal cortex, extending to the areas of the vestibular vestibular multisensoryel is caused by a lesion on the pathways, and these structures pulmonary disease(blockages in the arteries), hemorrhage (bleeding), tumor, multiple sclerosis plaques, vestibular migraine, and epilepsy may be due to transient ischemic attacks and rarely is connected to.
In order to distinguish central vertigo from others, the duration of vertigo, the characteristics of nystagmus and the accompanying neurological findings are helpful. Imaging methods such as cranial MRI, BBT, videonystagmography (VNG), electroencephalography (EEG) and blood tests can be used.

What is Vestibular / Basilar Migraine ?

Attacks are often accompanied by occipital headache or a feeling of pressure. Dizziness is accompanied by nausea and hearing loss.  During the attack, there is hypersensitivity to light and sound, vehicle retention increases.  The duration of dizziness is very variable, it passes in minutes, as well as there may be attacks that last for hours. Usually, patients have other types of migraines and have a family history of migraines.
If vertigo attacks, double vision, facial weakness, speech, or swallowing disorders accompanied by symptoms such as brain stem, changes in consciousness, psychomotor disturbances, and behavioral changes accompanied by basilar migraine is called.
It is necessary to distinguish basilar migraine from transient ischemic attack, Meniere’s Disease or vestibular paroxysms.

What is Peripheral Vertigo ?

Vertigo, which occurs due to lesions of the semicircular canals, utricle, saccule and vestibular nerve in the inner ear, is defined as peripheral vertigo.
Peripheral vertigo has 3 forms:

1.  Loss of peripheral vestibular function in both ears.

2. The main symptom is a feeling of swaying with head movements and a balance disorder in walking.Unilateral loss of vestibular function. The main symptom is dizziness and a tendency to fall in one direction.

3. Inappropriate stimulation of the peripheral vestibular system. There is inappropriate stimulation of the semicircular canals or the vestibular nerve. The main symptom ( for example, the pouring of crystals into semicircular channels) is dizziness in the form of attacks or in certain positions.

What are the Causes of Peripheral Vertigo?

Benign Paroxysmal Positional Vertigo ( BPPV)
It is formed as a result of the crystals in the inner ear being removed from their places and poured into semicircular channels.  It is usually seen after the age of 40. Rapid head movements and severe dizziness and nausea occur in certain positions. The diagnosis is made by neurootological examination and positional tests.

Vestibular Neuritis
It is thought that it occurs most often due to viral causes. It usually affects adults between the ages of 30-60 Dec. Unilateral vestibular insufficiency occurs. Constant dizziness, nausea, walking and balance disorders are observed. Very severe dizziness begins with nausea, vomiting and slowly recedes within a few weeks.

Meniere’s Disease
It is characterized by slow progressive hearing loss along with episodes of dizziness, a feeling of fullness in the ear and tinnitus. It usually starts between the ages of 40 and 60 Dec. It is formed by swelling of the labyrinth containing the endolymph in the inner ear and intermittent rupture of the membrane separating the endolymph and perilymph cavities. Although it is unilateral at the beginning, the other ear is also affected over time. It is important to exclude neurootological evaluation, clinical follow-up and other causes of dizziness for diagnosis.

Vestibular Paroxysm
There are episodes of dizziness that last for seconds or minutes, accompanied or not by complaints such as tinnitus and hearing loss. Unilateral hearing loss, tinnitus, and measurable vestibular dysfunction can occur during episodes, from time to time, or continuously. It is thought to occur due to vascular anomalies or with the dilation of the veins and pressure on the vestibular nerve at an advanced age. Another reason put forward is that it is triggered by the pressure of the central nucleus. Rarely, episodes of dizziness may be due to an arachnoid cyst that stretches the vestibular nerve. It is important to show vesibular nerve or nucleus pressure with imaging methods in diagnosis.

Bilateral Vestibular Insufficiency
Complaints of blurred vision during head movements and walking, especially balance disorders when walking in the dark and on uneven floors occur.  Patients most often complain about the movement of the environment while they are walking or running.
In 20-30% of bilateral vestibulopathy, the cause cannot be found. The most common causes are side effects of some medications, cerebellar degeneration, meningitis, labyrinthitis, auto-immune diseases, tumors, neuropathies and Meniere’s Disease.

Perilymph Fistula
In perilymph fistula and superior canal separation, coughing, sneezing, dizziness caused by loud noises are the complaints. The characteristics of dizziness may vary depending on the location of the fistula. The underlying cause is that pressure is being transmitted between the perilymphatic Decussation and the middle ear or the perilymphatic decussation and the intracranial decussation. As with any dizziness, it is essential to evaluate the patient with a neurootological examination for diagnosis, Cranial MRI and BBT can help in making a diagnosis.

What is Psychogenic Vertigo?

Somatoform disorders are the cause or contributor to a significant proportion of patients presenting with complaints of dizzines and dizziness. Somatoform disorder first appears without psychopathological complaints. Patients often complain of drowsiness, feeling dizzy and unsteadiness while walking. Depending on the underlying disease, complaints such as impaired motivation and concentration, decreased daily work and work performance, increased heart rate, nausea, sweating, inability to breathe, choking sensation, loss of appetite may accompany dizziness. Patients rarely show stressful situations and contradictions as the factor that triggers dizziness.

What are the Other Causes of Vertigo ?

All causes of dizziness other than central, peripheral and psychogenic causes are collected under this heading. Many metabolic, infectious, genetic diseases can lead to dizziness.
The most common other causes; presenkop, low blood pressure, heart rhythm disorders, trauma, diabetes, thyroid dysfunction, HIV, Epstein-Bar virus, Friedreich’s ataxia, and drugs.