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- Distinction between central and peripheral vertigo can be made clinically by way of close physical examination of nystagmus. The chart below describes specific findings for each:
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PERIPHERAL CENTRAL Nystagmus Direction Fast phase away from lesion; never reverses direction Sometimes reverses direction if looking in direction of slow phase Type Horizontal with torsional component, never purely torsional or vertical Can be in any direction Other neurologic signs Absent Often present Postural instability Unidirectional instability, walking preserved Effect of visual fixation Suppressed Not Suppressed Deafness or tinnitus May be present Absent
References
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