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Peripheral vs Central Vertigo
I have been having vertigo for about 2 months now. It has been getting better (less frequent) but i still occasionally get it. It has over the past couple months become a "once every other day" thing rather than a "2-3 times a day" thing like it used to be. It is true vertigo but i've also had moments of what i would call mental fog where things just dont seem clear but I can't put my finger on why.. The vertigo tends to last anywhere from 15-45 seconds and is usually provoked by me doing something.. I would say more than half of the time if I have an attack it is after i've exited my car after driving for a while. (I'll get out of my car and right when i reach my front door maybe 20 seconds later everything will start spinning) Only once has it made me nauseous. I've never had spontaneous vertigo while just sitting at my desk or anything like that. My doctor did say i had nystagmus in multiple directions in both eyes which would be more suggestive of central vertigo and after looking that up online it has me worried. Obviously only my doctor can give me an accurate diagnosis but i would like to know if my symptoms are more suggestive of one type of vertigo or another. My blood pressure is fine and I take Humira and Methotrexate for PsA.
MEDICAL PROFESSIONAL
Hello. Thank you for your excellent question.
Nystagmus, or rhythmic oscillations of the eyes, is usually in one direction (the fast beating component) toward the normal ear, whereas sometimes in central vertigo it can reverse direction. Also, in peripheral vertigo the nystagmus is horizontal, whereas in central vertigo it can be in any direction.
You can ask your physician about performing an MRI of your brain to rule out central causes such as stroke or brain mass, such as a vestibular schwannoma (acoustic neuroma).
Thank you,
Dr. S
Nystagmus, or rhythmic oscillations of the eyes, is usually in one direction (the fast beating component) toward the normal ear, whereas sometimes in central vertigo it can reverse direction. Also, in peripheral vertigo the nystagmus is horizontal, whereas in central vertigo it can be in any direction.
You can ask your physician about performing an MRI of your brain to rule out central causes such as stroke or brain mass, such as a vestibular schwannoma (acoustic neuroma).
Thank you,
Dr. S
I'll add that they couldn't provoke my vertigo in the office through any maneuvers and I had difficulty maintaining my balance when standing on a foam block with my eyes closed.
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