Central vertigo is a less common type of vertigo often associated with stroke, brain tumors, or other central nervous system conditions. A prompt diagnosis is important so you can get the right treatment for the underlying cause.

Vertigo describes symptoms of dizziness or spinning even though you’re standing still. While peripheral vertigo is the most common type and involves issues with your inner ear, some people may have central vertigo.

Instead of inner ear involvement, central vertigo develops from problems in your central vestibular system, which includes your brain and brain stem.

Sometimes, this condition is caused by serious underlying conditions. Central vertigo symptoms can be a possible sign of an emergency and should be evaluated right away.

Learn more about central vertigo, including its symptoms, complications, and treatment.

Central vertigo develops as a result of lesions in your central vestibular system. These lesions can block blood flow to nearby areas, such as your brain stem, inner ear, and cerebellum. As a result, vertigo symptoms may develop.

Some of the most common causes and risk factors of central vertigo include:

Other possible causes of this type of vertigo include:

Unlike lightheadedness, the dizziness experienced with vertigo can be described as uncontrollable feelings of spinning, despite physical stillness.

Dizziness is a symptom in vertigo more generally, but central vertigo also causes symptoms that impact your central nervous system, such as:

Severe balance issues are more likely in central vertigo. These can cause you to lose your ability to stand up or walk.

A vestibular migraine that causes this type of vertigo may also cause nausea and vomiting.

Symptoms of central vertigo are also more likely to have a sudden onset.

The exact complications of central vertigo depend on the underlying cause. For example, a stroke can cause long-term issues with vision, speech, and balance.

When left undiagnosed and untreated, central vertigo can become life threatening. This is especially the case if central vertigo is caused by a medical emergency, such as a stroke.

Central vertigo caused by brain tumors, injuries, and infections can also lead to life threatening complications.

All types of vertigo can increase your risk of injuries and bone fractures due to falls.

Both central and peripheral vertigo can cause feelings of dizziness. However, there are clear differences between the two.

Peripheral vertigo is much more common than central vertigo, making up about 90% of all vertigo cases. It develops from issues within your inner ear, and doesn’t have central nervous system involvement.

People who experience peripheral vertigo may also have symptoms not typically seen in central vertigo, such as:

  • tinnitus (ringing in the ears)
  • ear pain
  • hearing loss

Any recurring or chronic issues with dizziness should be assessed by a doctor.

Contact a doctor if you experience vertigo symptoms, especially if they appear suddenly.

Medical emergency

Call emergency medical services if you or a loved one also has possible signs of a stroke, such as sudden confusion, dizziness, or headache, balance problems, and weakness on one side of the body.

These symptoms may also be associated with a posterior circulation stroke.

Diagnosing central vertigo involves determining the underlying cause of your symptoms. This is especially important since some of the symptoms of central vertigo may be seen in a number of other conditions and may be misdiagnosed.

First, a doctor will ask you about your history of vertigo and how long the symptoms last. Typically, episodes that last several minutes or hours can point to a more serious cause.

A doctor will also run tests to assess your vision, gait, and balance, along with an ear exam and hearing test.

Based on their findings, a doctor may then order imaging tests of your brain. These can include a CT scan or MRI.

Diagnosing central vertigo may also involve ruling out other conditions, such as:

Most people with central vertigo are initially treated in a hospital.

Treatment goes beyond relieving vertigo symptoms and will likely involve addressing the underlying cause. For example, thrombolytic therapy to dissolve blood clots may be used in cases of central vertigo caused by a stroke.

Long-term central vertigo treatment may involve a combination of medications to treat the underlying cause, such as those for multiple sclerosis or migraine, possible surgery to remove tumors, or vestibular rehabilitation therapy (VRT) to improve balance.

Given all the possible causes of central vertigo, it’s not clear whether you can entirely prevent it.

Speak with a doctor about ways you can lower your risk of developing a stroke. Brain stem strokes can lead to a variety of symptoms and complications, including central vertigo.

Consider the below frequently asked questions about central vertigo that you may want to discuss further with a medical professional:

Is central vertigo dangerous?

Central vertigo can be a sign of a serious medical condition, such as a stroke, tumor, or infection. It’s important to get medical attention to receive an accurate diagnosis.

How do I know if my vertigo is central or peripheral?

Central and peripheral vertigo can both cause dizziness. However, central vertigo has additional symptoms related to your central nervous system. These include vision, balance, and speech problems.

While there are some key symptom differences between central and peripheral vertigo, the only way to confirm the type of vertigo you have is through diagnostic testing by a doctor.

Central vertigo is a less common type of vertigo that tends to have a sudden onset of symptoms. These can include classic symptoms of dizziness and spinning, as well as problems with vision and balance. The exact presentation depends on the underlying cause.