Abstract

There are two main types of vertigo: spontaneous and positional vertigo. Spontaneous vertigo can be divided into acute, recurrent and persistent depending on the disease course. Representatives of recurrent spontaneous vertigo are Meniere’s disease, migrainous vertigo, recurrent vestibulopathy, vertebrobasilar insufficiency, paroxysmal vertigo and acoustic neuroma. Meniere’s disease is characterized by episodes of vertigo, low pitched tinnitus, hearing loss and ear-fullness. Recently, endolymphatic hydrops could be visualized by magnetic resonance imaging after intratympanic gadolinium administration. Migrainous vertigo is a vestibular syndrome which presents episodic vestibular and concurrent migraines symptoms. Migrainous vertigo has a variety of clinical symptoms and neuro-otological findings. So the diagnosis of migrainous vertigo should depend on the clinical manifestations. Recurrent vestibulopathy has been defined as recurrent spells of vertigo lasting minutes to hours without auditory and neurological signs. Although recurrent vestibulopathy did not show any characteristic clinical findings, it deserves to be considered for differential diagnosis of episodic vertigo. Vertebrobasilar insufficiency refers to a temporary set of symptoms due to decreased blood flow in the posterior circulation of the brain. The intracranial MRA revealing narrowing of vertebral or basilar artery can be helpful in diagnosis. Ischemia in the vertebrobasilar artery system can cause vestibular symptoms due to peripheral vestibular dysfunction, central vestibular dysfunction, or both. Paroxysmal vertigo and acoustic neuroma can cause recurrent spontaneous vertigo although they are not common.