Peripheral Vs Central Vestibular Causes

When talking about Vestibular rehab (the fancy name for retraining balance and reducing dizziness and vertigo caused by the inner ear and related systems).

We loosely break it down into two broad categories – Peripheral (coming from the inner ear itself) or Central (coming from the brain or neurological pathways)

Examples of Peripheral conditions are:

• Benign Paroxysmal Positional Vertigo (BPPV) what most people refer to as vertigo
• Labyrinthitis or Vestibular Neuritis (Ear infection)
• Meniere’s Disease
• Bilateral Vestibular loss
• Semi Circular canal dehiscence

Examples of Central conditions are:

• Concussion or Head Injury
• Migraine
• Multiple Sclerosis
• Parkinson's Disease
• Cerebellar conditions
• CANVAS
• Stroke

(note: These lists are not a complete list of conditions)

Symptoms can be very similar between central and peripheral conditions and it is not uncommon to see some present with more than one vestibular issue. For example traumatic BPPV post concussion or BPPV with Parkinson's, Migraine triggered by BPPV.  This is why a full assessment is important to see where symptoms are stemming from and treat them appropriately 

A Physiotherapist trained in Vestibular rehab has the skills and knowledge to be able to distinguish between the two categories in testing and there are treatments for both central and peripheral conditions and then treat these effectively with positional manoeuvres, gaze stability and balance exercises to provide a well rounded program for recovery. 

Having dizziness and balance issues checked are important as they can be treated effectively and leaving them untreated increases a persons falls risk, not to mention reduced participation in the activities they enjoy doing because of ongoing symptoms and avoidance due to fear of causing their symptoms. Don't let dizziness hold you back, get it looked at today.