Central Vertigo vs. Peripheral Vertigo: What’s the Difference?


Vertigo is the terrible and unsettling sensation of having your environment whirl around you. It could also be a feeling that you are spinning out of control even though you’re not moving.  If you’ve ever ridden a spinning amusement park ride, you can understand firsthand what it feels like. However, for true sufferers, this feeling can happen for seemingly no reason, all of a sudden, at any time.

It’s important to understand that vertigo is not its own diagnosis.  Rather, it is a symptom that occurs with many conditions. It’s essential to understand where it’s coming from in order to take the right approach to care.  The two most common categories of vertigo are usually labeled as either central or peripheral. In short, the difference between central vertigo and peripheral vertigo is the source of where the symptom of spinning sensation is coming from.  Central vertigo is has to do with issues within the central nervous system (CNS). On the other hand, peripheral vertigo is typically due to problems in the inner ear.

Central Vertigo: Common Causes

By and large, central vertigo is less common than its counterpart, peripheral vertigo.  Central vertigo’s cause lies within the central nervous system. It is usually linked to irregularities in blood-flow and lack of proper oxygenation of the tissues of the CNS.  Some of the more frequent causes of central vertigo include:

Multiple Sclerosis (MS)

Multiple sclerosis is a disease that causes the erosion of the myelin sheath that surrounds nerve tissue.  This leads to impaired CNS function that can cause a variety of neurological symptoms, including vertigo.

Vestibular migraine

Vertigo and dizziness is a complaint that approximately 40% of migraine sufferers report.  Vestibular migraine may also be referred to as migraine-associated vertigo, or migraine-associated dizziness.

Vascular disease

Any condition that has a negative effect on blood flow has the potential to result in a false sense of spinning.  Atherosclerosis (plaquing in and hardening of the arteries), hypertension (high blood pressure), aneurysm (a weakening in the lining of an artery wall that balloons out and causes leakage), and embolism (blood clot in an artery that can become dislodged and migraine to the brain or vestibular system) are all examples of vascular diseases that can lead to central vertigo.


A stroke occurs either from abnormal bleeding on the brain (hemorrhagic) or from a lack of oxygen to brain tissue (ischemic).  A stroke is an urgent medical emergency, and vertigo can be one of the first symptoms to arise. If facial drooping and impaired speech are present, immediate emergency care should be sought out.  Transient ischemic attacks, or “mini” strokes, are also a possibility.


A tumor, whether benign or malignant, can be the cause of central vertigo.  Any tumor that affects CNS function, particularly in the area of the brainstem or the vestibulocochlear nerve, can result in vertigo.

Medication side-effect

Vertigo can be a side effect of many categories of medication, including antidepressants, anticonvulsants, blood pressure medications, contraceptives, sedatives, and anti-inflammatories.

Peripheral Vertigo: Common Causes

The inner ear plays a big part in your body’s ability to maintain its sense of balance.  Inner ear, or vestibular dysfunction, often leads to peripheral vertigo. The most common conditions associated with it are:

Benign paroxysmal positional vertigo (BPPV)

BPPV occurs when calcium crystals that are normally embedded within the inner ear dislodge and migrate into the fluid-filled canals where they don’t belong.  The crystals disturb the normal movement of inner ear fluid and send incorrect signals to the brain about head and body position, which leads to intense bursts of vertigo.

Meniere’s disease

Aside from severe vertigo attacks, Meniere’s disease sufferers will also experience tinnitus, fluctuating hearing loss, and the pressure or fullness in the affected ear.  


Your inner ear contains a network of fluid-filled canals and sacs that make up the labyrinth, which aids in both hearing and balance.  Infections, usually viral (but sometimes bacterial), can cause inflammation of the labyrinth and result in vertigo, tinnitus, and hearing loss.

Vestibular neuronitis

Like labyrinthitis, vestibular neuronitis causes inflammation of the vestibular nerve which sends signals from the inner ear to the brainstem about balance.  The main difference is that neuritis will only affect balance, while hearing remains intact.

Head or neck trauma

The onset of vertigo frequently occurs in the months or years following a head or neck injury, such as whiplash or concussion.  Vertigo is a common symptom that occurs in post-concussion syndrome as well.

Central or Peripheral, Natural Vertigo Relief is Possible

Since there is an established connection between head and neck injury and the development of vertigo, many people living with conditions are getting great results under upper cervical chiropractic care.  Upper cervical care is a subspecialty of the broader chiropractic profession that focuses on the area of the neck where it forms a junction with the skull. This area, the upper cervical spine, is consists of the occiput, atlas (C1), and axis (C2).  It is arguably the most complex area of the spine and has a unique function in that it must balance the weight of the head and also account for its range of motion. It is because of this freedom of movement that these vertebrae are particularly vulnerable to misaligning.

An upper cervical misalignment can contribute to vertigo by preventing normal brainstem function.  The brainstem is responsible for the processing and integration of balance signals. If it’s not doing its job right, vertigo can be the outcome.  Upper cervical chiropractors have a thorough understanding of this relationship and by performing a thorough analysis, can customize an adjustment that is tailored for each patient’s needs.  This exacting approach allows for gentle, effective adjustments that restore both normal alignment and normal function. Upper cervical care has already helped many vertigo sufferers regain their quality of life.  Before resigning yourself to living with the unknown of when your next episode might occur, schedule a consultation with an upper cervical chiropractor near you.





Find An Upper Cervical Doctor in Your Areato schedule a consultation today.

Find an Upper Cervical Specialist In Your Area

to schedule a consultation today.

Featured Articles


Montel Williams
Montel Williams

TV show host Montel Williams describes how specific chiropractic care has helped his body.

NBC's The Doctors

The TV show "The Doctors" showcased Upper Cervical Care.

CBS News/Migraine Relief

CBS News highlighted the alleviation of Migraines and Headaches.

The content and materials provided in this web site are for informational and educational purposes only and are not intended to supplement or comprise a medical diagnosis or other professional opinion, or to be used in lieu of a consultation with a physician or competent health care professional for medical diagnosis and/or treatment. All content and materials including research papers, case studies and testimonials summarizing patients' responses to care are intended for educational purposes only and do not imply a guarantee of benefit. Individual results may vary, depending upon several factors including age of the patient, severity of the condition, severity of the spinal injury, and duration of time the condition has been present.