Ayerbe I, Négrevergne M
Rua Bias Etxebarria 2-bajo, E-20600 Eibar (Gipuzkoa), Espagne.
Rev Laryngol Otol Rhinol (Bord). 2005;126(4):227-33.
Central vertigo is most often expressed by a feeling of dizziness, non or badly systematized, but it can also appear, more seldom, like an isolated acute vertigo or associated to other neurological signs. A precise clinical exam can lead to evidence essential clinical informations (significant ataxia, neurological signs, gaze nystagmus, pursuit anomaly,...). Almost all acute lesions of central vestibular pathways, as for the peripheral ones, lead to a harmonious vestibular syndrome. The vascular lesion of the vertebro-basilar territory and multiple sclerosis are two main causes to it. The pseudo-labyrinthine forms are essentially described in occlusion infarcts of the AICA and PICA, but a hematoma can lead to the same picture; the diagnostic of multi- or monosymptomatic forms with a peripheral lesion is often very difficult, the classical classification of the central and peripheral vestibular syndromes has become obsolete and should be abandoned.
中枢性眩晕最常表现为头晕感，不规律或严重无规律，但也较少见地表现为孤立的急性眩晕或伴有其他神经体征。精确的临床检查可得出重要的临床信息（明显共济失调、神经体征、凝视性眼球震颤、追踪异常等）。几乎所有中枢前庭通路的急性病变，与外周病变一样，都会导致一种协调的前庭综合征。椎基底动脉区域的血管病变和多发性硬化是其两个主要病因。假性迷路样形式主要见于小脑前下动脉（AICA）和小脑后下动脉（PICA）闭塞性梗死，但血肿也可导致相同表现；伴有外周病变的多症状或单症状形式的诊断通常非常困难，中枢和外周前庭综合征的经典分类已过时，应予以摒弃。
