Attention should be paid to the types of central dizziness caused by the brain and nerves

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Huynh An Thien - Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.
Feelings of dizziness, lightheadedness or spinning are very common discomforts, sometimes accompanied by nausea, unsteady posture, and wobbly gait. There are many causes for this condition; In which, central vertigo needs more attention, because this is a manifestation of damage in the brain. If not diagnosed and treated early, the disease can easily lead to dangerous complications.

1. What is vertigo?

Dizziness is a vaguely subjective state, but is often described as a feeling of spinning or tipping over, about to fall or toss out. Dizziness can also make us feel lightheaded, dizzy, or have difficulty walking as usual. Sometimes patients may report that even when lying still in bed, they still feel that they are moving or that the room is moving around them.
Besides dizziness, the patient also has other accompanying symptoms such as vomiting or nausea; headache or sensitivity to light or noise; double vision, trouble speaking or swallowing, or feeling weak in a limb; panting or sweating, heart palpitations...
When visiting the doctor, the patient should describe to the doctor how symptoms occur, how long they last, what triggers occur and any other related matters. These facts are clues to help determine if vertigo really is and find the cause of the vertigo and rule out diseases in other organs.
According to the specialist approach, dizziness has many different causes, related to the peripheral vestibular system located in the inner ear or to the brain. Accordingly, in some people, the problem is not severe, is repetitive, self-initiating and self-resolving; while in others, dizziness is potentially life-threatening.

2. What is central vertigo?

Unlike peripheral vertigo, which is caused by damage to the vestibular system located in the cochlea, central vertigo is caused by damage to the brain itself. In particular, lesions in the brain stem and cerebellum as well as the temporal lobes of the brain will cause a very intense feeling of dizziness.
Centralized vertigo can be a sign of the following health problems:
Ischemia, brain stroke such as Wallengerg's syndrome; Transient ischemic attack of posterior cerebral circulation, via basilar vertebral artery; Dissection of the vertebral artery; Brain hemorrhage; Proliferative neoplasms, such as supracerebral tumors; Demyelinating disease; Migraine of the basilar artery; Central nervous system infections; Multiple sclerosis; Temporal lobe epilepsy.

3. How to recognize central vertigo?

Both types of vertigo are characterized by hallucinations or delusions about body movements or the environment is spinning, out of balance. However, there are many differences that help distinguish central vertigo from peripheral vertigo. Accordingly, the doctor needs to base on the patient's detailed and detailed history and symptoms as well as the results from the diagnostic methods to determine the type of vertigo.
In benign postural paroxysmal vertigo - the most common form of peripheral vertigo, symptoms begin with head movement, as soon as the patient turns the head from bed, and subside with immobility, occur intermittently, each lasting only a few minutes, or recur and last up to a few days, a few weeks, and then go into remission. Central vertigo may be milder in severity, but it is continuous and tends to get worse. Because these are real brain injuries, it is difficult to heal on their own.
In addition, nausea and vomiting are often most severe in peripheral vertigo, while being less severe or may be completely absent in central vertigo. In contrast, central vertigo also has other focal neurological manifestations that peripheral vertigo does not have such as ataxia, gait, weakness in limbs, facial distortion, difficulty swallowing, difficulty speaking...

4. What to do when having central vertigo?

Because central vertigo is a consequence of diseases in the central nervous system, patients need to actively seek out the source of the damage and treat it promptly, to help localize it early and avoid the damage from spreading. Accordingly, when realizing that the characteristics of dizziness occur for the first time, unlike previous times, not related to posture, accompanied by weakness of limbs, it is necessary to take the patient to a medical center. in time to be examined by a doctor and taken a brain scan.
When the cause of central vertigo is found, it depends on each disease, such as ischemic stroke, cerebral hemorrhage, neoplasm, infection, multiple sclerosis, migraine or epilepsy. .., the patient will be given a specific treatment plan.
Different from benign paroxysmal vertigo - only need to be treated when a dizziness occurs, in addition to the attack does not need to take any medicine, the diseases that cause central vertigo require long-term medication, regular medical examination. period and to prevent future recurrences. In a few cases, surgical intervention may be necessary, especially when the brain has a tumor, a hemorrhage threatens to compress...
In short, dizziness is a feeling that everyone has experienced at least once. times in life, it usually goes away on its own without any treatment. However, do not be subjective because there are cases of dizziness this time can be due to a central cause. It is the confusion and delay in going to the doctor that can make the dizziness worse, accompanied by irreversible weakness and reduced quality of life later in life.
Reference source: Vietnam Neurological Association