<prompt> Difference between central and peripheral vertigo:Nystagmus associated with central vertigo is unidirectionalPurely horizontal nystagmus without torsional component is common in central vertigoCentral is more severe than peripheral vertigoTinnitus and deafness are often present in central vertigo  <response>: Ans. b Purely horizontal nystagmus without torsional component is common in central vertigo. Ref. Harrisons medicAine 16th ed. 132Differentiation Between Peripheral Labyrinth And Central BrainstemCerebellum Vertigo FeaturesPeripheral vertigoCentral vertigo1Direction of associated nystagmusUnidirectional fast phase opposite lesionBi or unidirectional2Purely horizontal nystagmus without torsional componentUncommonCommon3Vertical or purely torsional nystagmusNever presentMay be present4Visual fixationInhibits nystagmus and vertigoNo inhibition5Severity of vertigoMarkedMild6Direction of spinTowards fast phaseVariable7Direction of fallTowards slow phaseVariable8Duration of symptomsFinite minutes days weeks,May be chronic but recurrent9Tinnitus anddeafnessOften presentUsually absent10Associated central abnormalitiesNoneExtremely common11Common causesLabyrinthitis, Menieres, vestibular neuronitis, Ischemia, trauma, toxinVascular, demyelinating, neoplasms 