How are central causes of vertigo distinguished from peripheral causes?

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How are central causes of vertigo distinguished from peripheral causes?

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Title: How are central causes of vertigo distinguished from peripheral causes?
Author: Over, Darrell R.; Merritt, Edward J.
Date: 2011-01
Publisher: Family Physicians Inquiries Network
Citation: Evidence Based Practice 14(1): 11.
Series/Report no.: Help Desk Answers
Abstract: On bedside examination, the combination of a normal horizontal head impulse test, direction-changing nystagmus on eccentric gaze, and skew deviation (vertical ocular misalignment) has a high sensitivity and specificity for presence of a central lesion in vertiginous patients. (SOR: B, based on a cohort study.) For imaging, magnetic resonance imaging (MRI) is more sensitive than noncontrast computed tomography (CT) for early detection of central lesions. (SOR: C, extrapolated from a comparison cohort trial that included all stroke syndromes.)
URI: http://hdl.handle.net/10355/9926

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