2016 年 33 巻 3 号 p. 349-351
Vertigo/dizziness of the central origin is usually associated with other neurological signs or symptoms such as motor palsy, sensory deficit, dysarthria, ocular motor palsy, limb ataxia, and truncal ataxia. On the other hand, vertigo/dizziness of the peripheral origin is characterized by positional torsional nystagmus (posterior canal benign paroxysmal positional vertigo), direction–changing horizontal nystagmus (lateral canal benign paroxysmal positional vertigo), or unidirectional horizontal nystagmus (other acute peripheral vestibulopathies). Direction–changing horizontal nystagmus and unidirectional horizontal nystagmus can also be seen in the central vertigo/dizziness ; these nystagmus are caused by a disruption and/or cerebellar disinhibition of the vestibular nucleus.
Most peripheral vertigo/dizziness can be diagnosed by characteristic nystagmus, whereas neuroimaging study is necessary to confirm the diagnosis of central vertigo/dizziness. In the acute phase of vertigo/dizziness, antihistamine may be used to reduce symptom. For benign paroxysmal positional vertigo, the most common cause of vertigo/dizziness, canalith–repositioning maneuver is effective.
