Introduction
The pathophysiology of vertigo, page by page.
An interactive teaching atlas covering the peripheral and central causes of vertigo — anatomy, mechanism, examination, instrumented testing, imaging, and management — at three reading levels.
Vertigo is the illusion of movement, usually a spinning sensation, that arises when the balance organs of the inner ear or the parts of the brain that process balance disagree about where your head is in space. It is a symptom, not a diagnosis — and the job of the clinician is to work out which part of the system is sending the wrong signal.
This atlas walks through that detective work, starting with the anatomy and ending with the specific diseases — benign positional vertigo, neuritis, Ménière's, migraine, stroke, and the rest.
Vertigo is a false sensation of motion that reflects a mismatch between vestibular afferent input and the brain's expected percept of head position. It is best thought of as a symptom localised to either the peripheral apparatus (labyrinth, vestibular nerve) or the centralpathways (vestibular nuclei, cerebellum, brainstem, thalamus, cortex). The discriminator at the bedside is rarely the patient's description of the spin; it is the company the vertigo keeps — auditory symptoms, cranial neuropathies, gait, and the pattern of nystagmus.
Each module is structured the same way: anatomy, mechanism, clinical presentation, bedside examination, instrumented tests, imaging, differential diagnosis, management, and key teaching points, with references throughout.
Vertigo, narrowly defined, is the percept of self- or environmental motion in the absence of corresponding stimulus, and is one presentation within the broader vestibular syndromes described by the Bárány Society's International Classification of Vestibular Disorders. The taxonomy that matters at the bedside divides patients by temporal profile: acute vestibular syndrome (sudden, sustained), episodic vestibular syndrome (recurrent, self-limited), and chronic vestibular syndrome (persistent or long-standing) — each with its own peripheral and central differential, its own examination strategy, and its own red flags.
The atlas adheres to this triadic temporal frame. Bedside tools (HINTS, head-impulse, positional manoeuvres) are presented alongside the instrumented complements (vHIT, VEMP, caloric, audiometry, MRI), and disease pages link the mechanism to the expected pattern across every test.