What is central vertigo?
Central Vertigo is a clinical disorder where a person experiences an illusion of motion while remaining in an ideal balance. Vertigo caused by diseases of the Central Nervous System (CNS) is known as Central Vertigo.
One of the most common causes of Central Vertigo includes the lesion of the VIIIth cranial nerve.
Peripheral versus Central Vertigo
Vertigo caused due to troubles in the inner ear is called Peripheral Vertigo, and that caused as a result of disorders in the brain is called Central Vertigo.
When you talk about central vs peripheral vertigo, the central vertigo is related to the other brainstem signs and symptoms, while the peripheral vertigo shows predominantly vestibulocochlear signs and symptoms of vertigo, like tinnitus or hearing impairment. Here we shall see the central causes of vertigo
| Peripheral Vertigo | Central Vertigo | |
| Trigger | Problems in the inner ear | Problems in the Central Nervous System (CNS) |
| Cause | Benign Paroxysmal Positional Vertigo (BPPV), medicines that harm the inner ear structures. | Migraine, Multiple Sclerosis, certain drugs and alcohol. |
| Symptoms | Loss of hearing, dizziness, spinning sensation | Nystagmus, slurred speech, double vision, facial paralysis, swallowing difficulty. |
| Associated Symptoms | Tinnitus.No neurological symptoms associated. | They are typically associated with neurological symptoms. |
| Imbalance | Moderate | Severe - Difficulty in standing and walking |
| Onset | Sudden | Gradual |
| Duration | In seconds | It is continuous |
| Intensity | Severe | Mild |
| Effect of Head position | Induces Vertigo with BPPV and aggravates Vertigo with vestibular neuritis | Little change occurs. Can worsen, with a change in head position. |
Causes of Central Vertigo
The primary cause of Central Vertigo is a disease of the Central Nervous System (CNS) usually involving a lesion in the VIIIth cranial nerve. It can also be brought on by a variety of other factors.
Head injuries
30-65% of patients with head injury suffer from imbalance or Vertigo. Following are some of the several reasons for dizziness after a head injury:
- Migraines
- Dehydration
- Issues in the inner ear
- A pinched nerve in the neck
- Blood pressure or anti-seizure medications
- Low blood pressure
- The cerebellum, the part of the brain which is responsible for balance has been damaged.
- The occipital lobe, the part of the brain that controls eye movement and vision, has been damaged.
The vestibular system can become damaged after a head injury. This happens when otoliths are displaced in the semicircular canals, when there is a fluid leak in the inner ear or when the nerve connection between the brain and the vestibular system is impaired.
Certain types of exercises like balancing exercises, Epley manoeuver, Semont manoeuver and Brandt-Daroff exercises are found to be helpful in the treatment of Vertigo caused by head injury.
Multiple sclerosis
The frequent culprit for the cause of Central Vertigo is a lesion around the brain stem or on the cerebellum.
Vertigo could be caused by a new lesion or by an older and growing lesion. A person may become dizzy if any lesion alters the routes of the signals that help to maintain the body’s balance.
Dizziness and Vertigo can make it difficult to complete daily chores and increase the risk of falling.
Brain tumours
While a brain tumour is unlikely to induce dizziness directly, some tumours can produce headaches, nausea and vomiting, which can be coupled with a dizzy feeling. This is especially true if a person is dehydrated as a result of frequent vomiting.
Tumours in the cerebellum, the portion of the brain that controls movement, can induce Vertigo, which is characterised by dizziness and a spinning sensation of the surrounding.
Strokes
Stroke has the potential to modify the process by which the brain influences the body’s balance leading to unsteadiness. There are various additional reasons for balance issues, and treating the underlying cause can help to improve balance.
If a stroke occurs in the cerebellum or brainstem, the parts of the brain that control balance, a person may experience Vertigo. It’s possible for a person to feel dizzy or lose equilibrium due to a stroke.
Illness or infection affecting the cerebellum
Central Vertigo arises as a result of issues in the brain, especially in the brain stem or the hindbrain (cerebellum). Therefore, an illness that affects the cerebellum causes Central Vertigo.
The infection of the brain causes a sensation of spinning (Vertigo), loss of hearing and other Vertigo symptoms.
Migraines
Repeated dizziness or Vertigo caused due to nervous system problems is called Vestibular migraine. The frequency of headaches is less compared to a normal migraine.
Symptoms may include imbalance, nausea, vomiting, disorientation, confusion and motion sensitivity.
Medications can help treat these migraines. Migraine-triggering foods can also be avoided to prevent frequent migraine episodes.
Transient Ischemic Attacks (TIA)
Transient Ischemic Attacks are a common cause of the vestibular syndrome and most commonly result in Central Vertigo than Peripheral Vertigo.
Frequent symptoms of TIA include dizziness with or without related neurological symptoms.
To avoid recurring and potentially disabling or fatal ischemia events, it is critical to recognise isolated dizziness presenting as TIA.
It is also necessary to adequately evaluate the underlying TIA mechanism, implement early treatment where necessary and undertake risk factor management initiatives.
Vascular diseases
Conditions that impair the blood flow can cause Central Vertigo in some cases, such as Hypertension, Atherosclerosis, Embolism and Aneurysm.
- Hypertension is the persistent rise of blood pressure in the arteries.
- Atherosclerosis is a disease in which plaque builds up in the walls of the arteries. It narrows or hardens the arteries over time.
- Embolism is a condition in which a foreign body, such as a blood clot or an air bubble, becomes lodged inside a blood vessel.
- Aneurysm is a weakening of the arterial wall’s lining. The artery will bulge or balloon as a result of this and lead to stroke on leaking or rupturing.
Central Vertigo symptoms
Double vision, dizziness, walking difficulty, troubles in swallowing, headaches and imbalance are some of the common symptoms of Central Vertigo.
A few other frequent symptoms include:
Inability to maintain focus
Nystagmus occurs in certain people where there is uncoordinated eye movement resulting in blurred vision.
Cold sweats
With the rise in anxiety levels and the inability to stabilise oneself due to frequent Vertigo, cold sweats occur.
Headaches
Headache is common in Central Vertigo due to the recurrent spinning sensation. The pain initiates on one side of the head and gradually spreads to the back and the neck.
Limited mobility
Since the trigger point for Central Vertigo is the brain stem, which is encased by the cervical spine, a person’s ability to move smoothly may be hindered.
Treatment of Central Vertigo
Central Vertigo can be caused by various factors, and identifying the root cause aids in figuring out the method of treatment.
Medications can be given to alleviate the symptoms and make the Vertigo episodes more bearable.
True Vertigo should be distinguished from dizziness and other forms of disequilibrium before beginning treatment. Once Vertigo has been confirmed, the underlying cause can be investigated.
Prescription medications
There are varieties of medications that help to treat Central Vertigo based on its cause.
Most frequently used drugs include antihistamines, diuretics, benzodiazepines and corticosteroids.
Meclizine, promethazine, diazepam, lorazepam and prednisone are the most commonly prescribed medications.
Drowsiness, headache, nausea, vomiting, dizziness and lightheadedness are some common adverse effects of Vertigo medication. Consulting a doctor is necessary to evaluate the cause and get the right treatment.
Chiropractic care
Chiropractic care can treat Vertigo arising from various causes. Chiropractors employ a variety of specific treatments to aid in the treatment of Vertigo.
The natural force of gravity is used in chiropractic treatment to displace the calcium carbonate crystals in the inner ear through gentle manipulation and well-tolerated adjustments.
The symptoms may greatly subside or may disappear after 3-4 treatments.
Home remedies for Central Vertigo treatment
Certain home treatments can help avoid Vertigo attacks or help people with Vertigo manage their daily lives.
Remedy 1
- Wheat grain - 2 tablespoon
- Poppy seeds - 1 teaspoon
- Almonds - 8
- Watermelon seeds - 8
All the ingredients are soaked in water and ground into a paste. In a pan, 2 cloves can be fried with 1 teaspoon of ghee along with the paste. This can be mixed with milk and consumed daily for a week.
Remedy 2
Getting adequate sleep and relaxing the body may help reduce the symptom of nausea and dizziness.
Remedy 3
1 teaspoon of amla powder and 1 teaspoon of coriander powder are soaked in water overnight. It is consumed after straining and adding sweetness if required.
Remedy 4
A healthy diet containing adequate vitamins and minerals helps to treat Central Vertigo.
Remedy 5
Raw ginger can be consumed in the form of tea due to its ability to control blood pressure. They are also helpful in treating nausea and vomiting which are symptoms of Vertigo.
Remedy 6
Refraining from rapid movements that could cause imbalance while waking up or while sitting.
Remedy 7
Improve hydration by increasing liquid intake, especially in the form of juice.
Remedy 8
One of the most nourishing superfoodss, almonds are beneficial to persons with Cervical Vertigo. Powdered almonds can be mixed with warm milk and consumed to treat the symptoms of Vertigo.
Remedy 9
To treat nausea and headache, two common symptoms of Central Vertigo, salt, black pepper and lemon juice are mixed, in a glass of warm water and consumed. This prevents Vertigo attacks.
Remedy 10
A strawberry and yoghurt mixture helps to relieve the issues that cause Vertigo.
Yoga Poses for Vertigo
The following are a few yoga poses that help people with Central Vertigo. An individual with central vertigo is advised to perform the yoga poses under expert supervision to prevent injuries.
Child’s pose
The Child’s pose is said to calm the mind and is very relaxing. During Vertigo attacks, this pose resolves dizziness. With regular practice of the child’s pose, the nervous system is strengthened.
Steps of Child’s pose:
- The person must stay focused.
- As the knees are widened, the feet are brought together.
- The abdomen is rested on the thighs while the feet are rested on the buttocks.
- The forehead is then gradually placed on the ground.
- The foot must be held by the palm.
- The person must stay in this position for a few minutes before returning to the normal position.
Viparita Karani
Viparita Karani is one of the most effective asanas to treat Vertigo. This asana has the effect of calming the mind and providing relief from Vertigo-related headaches.
Steps of Viparita Karani
- The person performing Viparita Karani must close their eyes which is also helpful to regain a sense of balance.
- The legs are then raised against the wall with the person in a sitting position.
- Now, they can lay down and stretch their arms out to the sides, folding at the elbows. This is supposed to look like a cactus.
- Slow, deep breaths can be taken with eyes closed till the person feels relaxed.
- The person must stay in this position for a few minutes before releasing from the position.
Corpse pose
The Corpse pose is done for body relaxation.
Steps to perform the corpse pose:
- The person must lie on their back and allow their arms and legs to stay at roughly 45 degrees to the sides of the body. It is recommended to stay warm or else to be covered in a blanket.
- With eyes closed, slow and deep breaths are taken through the nose. The body gets completely relaxed with time, and now the focus must be on the body’s rise and fall during breathing.
- Scanning the body from fingers to toes with the mind will reveal regions of tension, constricted muscles and rigidity. The person should relax and release these muscles consciously.
- The individual must lose all control over their thoughts, body and breath. The body is made to sink further into a state of profound relaxation.
- This position is to be held for 5 to 15 minutes.
- To release, deep breaths must be taken gradually. Toes and fingers should be wiggled. The entire body has to be stretched out with arms reaching over the head. The knees are bent into the chest to resemble the fetal position. When ready, the person has to slowly inhale while returning to a seated position.
Pranayama, paschimottanasana, shanmukhi Mudra and halasana are few other yoga poses that are beneficial to persons suffering from Vertigo.
Precautions
- Doctor consultation is necessary before practising any form of yoga or exercise.
- Wall can be used as support in case of imbalance.
- While practising forward bends, carefully stand up or sit down without causing a jerk.
- The neck position is very critical and so careful movement of the neck is required.
Conclusion
Central Vertigo is caused due to diseases of the central nervous system. Blurred vision, cold sweats, headache and limited mobility are a few symptoms of Central Vertigo.
Medications and chiropractic care are the most used treatments apart from home remedies and yoga poses.
FAQ's
1.What is the most common cause of Central Vertigo?
The most common cause of Central Vertigo is problems in the Central Nervous System (CNS).
2.Is Central Vertigo a serious issue?
The cause of Central Vertigo is a factor in deciding the seriousness of the disease. Since Central Vertigo involves CNS and the brain, it is generally quite serious. Proper diagnosis and treatment are required to have it under control.
3.How is Central Vertigo diagnosed?
The best imaging test for Central Vertigo is an MRI brain scan. Medical history, eye movement testing and neurological testing are a few other diagnosing methods.
4.How long does Central Vertigo last?
Vertigo attacks can range from a few seconds to several minutes, hours or even days. It lasts longer than Peripheral Vertigo.
Can Central Vertigo be positional?
Central Positional Vertigo (CPV) is an uncommon cause of positional Vertigo. It is due to structural lesions in the cerebellum, mainly the uvula and cerebellar nodulus.
5.What are Central Vestibular Disorders?
Brainstem strokes, head trauma, migraine-related vestibulopathy, Multiple Sclerosis, and cerebellar degeneration are the most prevalent Central Vestibular Disorders (CVDs).
6.What is the difference between Peripheral and Central Vestibular Disorders?
Peripheral Vascular Disorders (PVDs) refers to the pathology affecting the inner ear vestibular structures as well as the vestibular part of the eighth cranial nerve.
Neuritis, labyrinthitis, Meniere's disease, BPPV and acoustic neuroma are examples of PVDs.
