Although peripheral vestibular disorders account for the most cases of dizziness or vertigo, approximately 11-15% of patients have central vestibulopathy. This remains a diagnostic challenge for neurotologists, as it can present with acute vestibular syndrome (AVS) in isolation without other obvious neurologic deficits....
Clinicians should maintain awareness that 11–15% of dizziness presentations may have a central (brain-based) cause; however, this review does not introduce new diagnostic criteria or protocols that would change existing assessment workflows.
Misdiagnosing central vestibular syndromes as peripheral can delay life-threatening diagnoses such as stroke, making accurate differentiation a critical clinical skill for audiologists and ENT teams.
- 01Approximately 11–15% of dizziness/vertigo patients are estimated to have a central vestibular cause.
- 02Central vestibular syndromes arise from pathology in the brain (brainstem, cerebellum, cortex) rather than the inner ear.
- 03Distinguishing central from peripheral vestibular disorders remains a significant diagnostic challenge.
- 04Narrative review format synthesises existing literature rather than presenting new primary data.
- 05Published in Clinical and Experimental Otorhinolaryngology.
Approximately 11–15% of patients presenting with dizziness or vertigo have central vestibulopathy.
studypartially supportedCentral vestibular syndromes pose significant diagnostic challenges in clinical settings.
opinionsupported- PMID
- 42438433
- DOI
- 10.21053/ceo.2026-00155.
- Journal
- Clinical and Experimental Otorhinolaryngology
- Publication type
- review
- Evidence level
- 5
- Population
- Patients presenting with dizziness or vertigo (literature-based; no primary patient cohort)
- Intervention
- Narrative review of central vestibular syndrome classification and diagnosis
Primary outcomes
Characterisation of central vestibular syndrome subtypes; Diagnostic differentiation from peripheral vestibular disorders