Nystagmus and central vestibular disorders.

PURPOSE OF REVIEW: This review will cover the recent advances in clinical and laboratory features, pathophysiology, and treatment of central vestibular disorders.

RECENT FINDINGS: Several features and mechanisms of central nystagmus have been identified over the years. Application of head impulse tests and vestibular evoked myogenic potentials has expanded our understanding of altered processing of canal-driven and otolith-driven vestibular signals in lesions involving the central vestibular structures. Integrated approach based on the symptoms and neurotologic signs enhances the diagnostic accuracy of acute vascular vertigo. Identification of isolated central vestibular syndromes has improved the diagnosis of central vertigo and our understanding of anatomic and functional organization of the central vestibular structures.

SUMMARY: With the developments of clinical and laboratory neurotology, the spectrum of central vestibular disorders has expanded markedly over the years.