NEURO-OPHTHALMOLOGY AND NEURO-OTOLOGY: Edited by José-Alain Sahel, Michael Strupp and David ZeeCentral vertigoChoi, Jeong-Yoona,b; Lee, Seung-Hanc; Kim, Ji-Sooa,bAuthor Information aDizziness Center, Seoul National University Bundang Hospital bDepartment of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam cDepartment of Neurology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Korea Correspondence to Ji-Soo Kim, MD, PhD, Dizziness Center, Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea. Tel: +82 31 787 7463; fax: +82 31 719 6828; e-mail: firstname.lastname@example.org Current Opinion in Neurology: February 2018 - Volume 31 - Issue 1 - p 81-89 doi: 10.1097/WCO.0000000000000511 Buy Metrics Abstract Purpose of review This review considers recent advances in central vertigo in terms of clinical and laboratory features and pathophysiology. Recent findings Strokes presenting dizziness–vertigo are more likely to be associated with a misdiagnosis in the emergency setting. The risk of future strokes after discharge is higher in patients diagnosed with peripheral vertigo than in control patients. Strokes and transient ischemic attacks account for one-quarter of acute transient vestibular syndrome. Diagnosis of acute combined central and peripheral vestibulopathy such as anterior inferior cerebellar artery infarction requires additional consideration whenever applying the HINTS (head impulse test, direction-changing gaze-evoked nystagmus, and test of skew). Heat illness and metronidazole have been recognized as new causes of central vestibulopathy. Some new findings have also been added to the clinical and laboratory features of central vertigo. Summary Central vertigo is a heterogeneous group of disorders with diverse clinical spectrums. An integrated approach based on understanding of clinical features, laboratory findings, speculated mechanisms, and limitations of current diagnostic tests will lead to better clinical practice. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.