2025 Volume 84 Issue 4 Pages 219-225
To differentiate dizziness of central origin, it is necessary to focus on neurological signs and symptoms other than dizziness. However, the pathology of dizziness cannot be determined from neurological signs/symptoms other than dizziness.
Like peripheral dizziness, central dizziness is often caused by vestibular imbalance, more precisely, a disruption of the central vestibular pathway, which includes not only the horizontal, but also vertical and rotational directions. Vestibular imbalance is reflected in eye deviation and nystagmus. Therefore, even in cases of central dizziness, the pathology causing the dizziness can be identified by using Frenzel glasses to evaluate eye deviation and nystagmus. Actually, in clinical practice, it is much more useful to use Frenzel goggles to correctly evaluate vestibular imbalance, the main cause of dizziness, rather than engage in a systematic differential diagnosis of dizziness in a broad sense, including circulatory insufficiency and anemia.
When differentiating central dizziness, it is not sufficient to look for neurological signs/symptoms other than dizziness. It is also necessary to identify the underlying pathology of the dizziness using Frenzel goggles.
