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Distinguishing Peripheral and Central Vestibular Vertigo

Peripheral Vestibular Vertigo Central Vestibular Vertigo
Lesion Location Inner ear vestibular receptors and vestibular nerve lesions Vestibular nerve nuclei and central pathways lesions
Severity and Duration of Vertigo Paroxysmal, severe symptoms, short duration Mild symptoms, long duration
Nystagmus Small amplitude, mostly horizontal or horizontal with rotation Large amplitude, variable forms
Cochlear Symptoms Often accompanied by tinnitus, hearing loss, etc. Not obvious
Autonomic Symptoms Nausea, vomiting, sweating, pale complexion Rare and not obvious
Vestibular Function Test No response or reduced response Often normal response

Explanation

Vertigo: Vertigo is the illusion of movement, such as spinning, rising, or tilting, experienced by the patient. It is often accompanied by instability in standing and walking, nystagmus, and autonomic symptoms like nausea, vomiting, sweating, and pale complexion due to the connection between vestibular organs and the autonomic centers in the brainstem reticular formation.

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