Symptom characteristics

Central vertigo

Peripheral vertigo

Sensation of circular motion

Often a vague, difficult to describe feeling of imbalance or collapse, with unstable posture and unsteady gait

Sensation of circular motion

Onset of symptoms

Often insidious and difficult to determine

More often sudden, paroxysmal

Severity

Moderate or mild

Severe

Course

Stable or slowly variable

Most severe symptoms at onset, usually resolving gradually

Duration of a single episode

A few seconds; may result in falling

From several minutes to several hours

Duration of symptoms

Months, years

Up to a few weeks

Head movements

Minor effect on symptoms

Worsening of vertigo

Closing the eyes

No effect on symptoms

Improvement of vertigo

Disturbances of consciousness

Possible

None

Seizures

Possible

None

Headache

Often

Rare

Visual disturbances

Diplopia, scotomas, impaired visual acuity

None

Symptoms of central nervous system damage

Often paresis of the limbs and cranial nerves, ataxia, dysarthria, Horner syndrome (ptosis, constriction of the pupil, sinking of the eyeball), or other neurologic deficits

Isolated peripheral paresis of the facial muscles may occur

Hearing disorders

None

Hearing loss, deafness, tinnitus, feeling of fullness in the ear

Visual fixation

Vertigo does not stop

Vertigo stops