Temporal characteristics of vertigo attacks:
Sudden onset: peripheral vertigo
Gradually worsening: central vertigo
Intermittent: Peripheral vertigo
Persistent: central vertigo
Episodic rotational vertigo.
Few seconds: caused by transient stimulation or reduced 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 labyrinthitis, 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 basilar artery