Almost every day, patients ask me questions about vertigo, and I try to answer them to the best of my knowledge, but sometimes the letters are just a few words, and sometimes they are so long and detailed that it is not easy to make sense of them. I know it’s not their fault, but the urgency of seeking medical attention and treatment has led to this. What I want to say here is that the history of vertigo is very important, and it is important to tell me the history clearly so that I can quickly clarify my thoughts and respond as quickly and accurately as possible.
I hope the reader will find it useful to know the characteristics of vertigo attacks in terms of time, number of attacks, and accompanying symptoms.
Temporal characteristics of vertigo attacks:
Sudden onset – peripheral vertigo
Gradually increasing – central vertigo
Intermittent-peripheral vertigo
Persistent – central vertigo
Temporal characteristics of vertigo attacks:
Episodes of rotational vertigo
Few seconds: caused by a brief stimulation or decrease in the function of one side of the vagus or its central connections. bppv, vagal fistula, temperature effect, pressure change vertigo, post-concussion syndrome, hyperventilation syndrome
Several minutes: recurrent episodes several times a day. Vertebrobasilar artery dysfunction, cervical vertigo
Within minutes to 24 hours: vagal pathology. Meniere’s disease, delayed labyrinthine effusion, early syphilitic labyrinthitis, vestibular epilepsy
Delayed rotational vertigo
More than 24 hours less than 3 to 4 weeks: destructive lesions of the vagus or vestibular pathways. Vestibular neuritis, bacterial and viral vaginitis, internal auditory artery syndrome, head trauma, vagal oscillations, window membrane rupture, skull base fracture, multiple sclerosis
Number of episodes of vertigo:
Single episodes: vaginitis, vestibular neuritis, sudden deafness, traumatic ear injury, window membrane rupture
Recurrent episodes: Meniere’s disease, BPPV, vascular vertigo
Vertigo attacks during vertigo :
Onset in supine position during sitting up or lying down – Vertebrobasilar artery transient ischemic vertigo and cervical vertigo
Onset in certain head or body positions – BPPV
Concomitant symptoms of vertigo
Cochlear symptoms before, after or at the same time as vertigo attack – Periventricular disorders
Neurological symptoms – Central nervous system disorders
Vegetative symptoms – periventricular disorders
Neck pain, shoulder pain, numbness and weakness of upper and lower extremities – transient ischemic vertigo and cervical vertigo of the vertebral basilar artery