What are the causes of central vertigo?

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What are the causes of central vertigo?

Central vertigo is caused by disturbances or dysfunctions in the central nervous system (CNS), particularly the brainstem or cerebellum, which are responsible for processing balance and spatial orientation. Central vertigo is typically associated with more serious conditions than peripheral vertigo, and it often involves neurological symptoms beyond just dizziness or vertigo.

Here are the primary causes of central vertigo:

1. Stroke (Cerebrovascular Accident)

A stroke affecting the brainstem or cerebellum can impair the brain’s ability to process sensory information related to balance and spatial awareness. Strokes in these regions often lead to central vertigo, as well as other neurological deficits such as weakness, numbness, or difficulty with coordination and speech.

2. Multiple Sclerosis (MS)

MS is an autoimmune disease that affects the central nervous system, particularly the myelin sheath that surrounds nerve fibers. Demyelination in areas of the brainstem or cerebellum can cause dizziness, vertigo, and a variety of other neurological symptoms, including vision problems, muscle weakness, and sensory disturbances.

3. Brain Tumors

Tumors in the brainstem or cerebellum can compress or disrupt the normal functioning of the areas responsible for balance. These tumors can cause persistent vertigo, along with other symptoms such as headaches, nausea, and neurological impairments.

4. Vestibular Migraine

Vestibular migraines, also called migraine-associated vertigo, can cause vertigo and dizziness in addition to the typical migraine symptoms. The vertigo associated with vestibular migraine can be episodic and often involves sensitivity to light or sound, nausea, and visual disturbances.

5. Cerebellar Ataxia

Cerebellar ataxia refers to a group of disorders that affect the cerebellum, the part of the brain responsible for coordinating movement and maintaining balance. Dysfunction in the cerebellum can lead to impaired coordination, dizziness, and vertigo.

6. Chiari Malformation

In a Chiari malformation, part of the cerebellum extends into the spinal canal, which can disrupt the normal flow of cerebrospinal fluid and put pressure on nearby brain structures. This malformation can lead to symptoms such as vertigo, headaches, and balance difficulties.

7. Traumatic Brain Injury (TBI)

Head trauma or a concussion can damage the brainstem or cerebellum, resulting in central vertigo. Depending on the severity of the injury, vertigo may be accompanied by other symptoms such as memory loss, difficulty concentrating, and sensory changes.

8. Infections Affecting the Brain (Encephalitis)

Encephalitis is inflammation of the brain, typically caused by a viral infection. If the infection affects the brainstem or cerebellum, it can cause symptoms like vertigo, nausea, headaches, and other neurological impairments.

9. Wernicke’s Encephalopathy

Wernicke’s encephalopathy is a condition often caused by thiamine (vitamin B1) deficiency, particularly in individuals with alcoholism. It affects the brainstem and can lead to vertigo, confusion, memory problems, and muscle coordination issues.

10. Parkinson’s Disease

Parkinson’s disease, a neurodegenerative disorder that affects movement, can also lead to balance issues and vertigo. The disease affects areas of the brain that control movement and coordination, leading to dizziness, shakiness, and difficulty with balance.

11. Neurodegenerative Diseases (e.g., Alzheimer’s Disease)

Other neurodegenerative conditions, like Alzheimer’s disease or frontotemporal dementia, can also affect the areas of the brain involved in balance and coordination. In advanced stages, individuals with these conditions may experience vertigo or dizziness.

12. Vertebrobasilar Insufficiency

Vertebrobasilar insufficiency refers to reduced blood flow to the brainstem or cerebellum, often caused by atherosclerosis or blood vessel narrowing. This condition can cause symptoms like dizziness, vertigo, and visual disturbances, and it may be linked to a higher risk of stroke.

13. Migrainous Vertigo (Migraine-Related Dizziness)

Migraine can sometimes cause vertigo and dizziness without the typical headache. This phenomenon, known as migrainous vertigo or vestibular migraine, may also be accompanied by visual disturbances, nausea, and sensitivity to light and sound.

14. Acoustic Neuroma

An acoustic neuroma (also called a vestibular schwannoma) is a benign tumor that grows on the vestibular nerve. Though acoustic neuromas are more commonly associated with peripheral vertigo, large tumors or those affecting the brainstem can cause central vertigo symptoms as well.

15. Neurovascular Disorders

Neurovascular disorders, including conditions that affect blood vessels in the brain, may lead to vertigo. For example, vertebral artery dissection or other vascular abnormalities may disrupt blood flow to the brainstem or cerebellum, resulting in dizziness or vertigo.

16. Autoimmune Disorders (e.g., Lupus, Sjogren’s Syndrome)

Some autoimmune diseases, such as systemic lupus erythematosus (SLE) and Sjogren’s syndrome, can affect the brainstem or cerebellum and lead to central vertigo. These diseases often cause widespread inflammation, which can involve neurological symptoms.

17. Increased Intracranial Pressure

Increased pressure inside the skull, due to conditions like hydrocephalus, brain tumors, or intracranial hemorrhage, can compress the brainstem and affect the vestibular system, leading to central vertigo and other neurological symptoms.

Summary of Common Causes of Central Vertigo:

Stroke
Multiple sclerosis
Brain tumors
Vestibular migraine
Cerebellar ataxia
Chiari malformation
Traumatic brain injury
Infections (encephalitis)
Wernicke’s encephalopathy
Parkinson’s disease
Neurodegenerative diseases (e.g., Alzheimer’s)
Vertebrobasilar insufficiency
Acoustic neuroma
Neurovascular disorders
Autoimmune disorders

Conclusion:

Central vertigo arises from dysfunction in the brainstem or cerebellum, which are vital for balance and coordination. It is often associated with more serious, chronic, or progressive conditions, and it is important to identify the underlying cause through a thorough medical evaluation. Treatment typically focuses on addressing the root cause of the central vertigo, along with symptom management.