Central Vertigo

Vertigo that is caused by problems with the central processor (the brain) is relatively uncommon. The most common cause of this type is vertigo in association with migraine headaches. Migraine headaches often begin with an “aura”. This is a sensation that varies, but can be anywhere from flashing lights to wavy lines to vertigo. The vertigo associated with migraine headaches usually lasts for less than an hour and is almost always followed by a migraine headache. This kind of vertigo is typically well controlled with standard anti-migraine medications.

The addition of a beta-blocker, like propranolol, may be useful to decrease the frequency of the headaches and also prevent the vertigo. Problems that directly affect the brain, like strokes, TIAs, and multiple sclerosis can cause vertigo. However, vertigo in these cases is often a consequence of the more major illness. Vestibular therapy is the mainstay of treatment.