ABSTRACT
This chapter explores the pathological conditions of the peripheral and central vestibular system. Complaints of ‘dizziness’, ‘vertigo’, ‘off-balance’ and ‘lightheadedness’ can be, and often are, used interchangeably by patients. Vertigo is the inappropriate perception of self-motion. It is usually used to describe a rotatory or spinning sensation, and the visual world is often seen as spinning too. Headache with vertigo may suggest a migrainous cause, but a secondary headache can also result from recurrent attacks of vertigo. Dizziness, vertigo or imbalance may be prominent symptoms of anxiety disorders or panic attacks. The vestibulo-ocular reflex stabilizes vision with head movement in all directions. The most common cause of an acute episode of vertigo is ‘vestibular neuritis’, ‘labyrinthitis’ or ‘acute idiopathic unilateral peripheral vestibulopathy’: these terms are used interchangeably. Vestibular neuritis usually affects the superior division of the vestibular nerve that carries signals from the superior and horizontal semicircular canals.
