[Vertigo and pathology of the cerebellospinal system]

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.