Table 2. Differentiation of peripheral vertigo, central vertigo, and CBZ toxicity.

This table compares key features of peripheral vertigo, central vertigo, and CBZ toxicity. It highlights differences in symptoms, triggers, and physical findings, helping clinicians distinguish CBZ toxicity from other causes of dizziness.

CT: computed tomography; MRI: magnetic resonance imaging; CBZ: carbamazepine

Types of Vertigo	Peripheral Vertigo	Central Vertigo	Carbamazepine Toxicity (Drug-Induced Vertigo)
Associated Symptoms	Tinnitus, hearing loss, ear fullness, nausea	Neurological symptoms (paralysis, numbness, speech impairment, diplopia), nausea, headache	Fatigue, drowsiness, nausea, confusion, ataxia, decreased consciousness, arrhythmia, syncope
Onset	Acute, episodic	Sudden or gradual, persistent	Acute, persistent
Triggers	Positional changes (head or body)	No specific triggers	Dose increase, addition of other medications
Physical Findings	Horizontal nystagmus, direction-fixed nystagmus, mild balance disturbance, inner ear impairment	Vertical or direction-changing nystagmus, skew deviation, diplopia, dysarthria, dysphagia, dysphonia, dysmetria, dysdiadochokinesis	Vertical nystagmus, myoclonus, delayed reactions, impaired consciousness, seizures, diplopia, dysarthria, dysphagia, various other neurological findings
Additional Tests	Hearing tests, caloric testing, positional nystagmus tests (vestibular function tests)	Brain MRI, CT, neurological examinations	Blood carbamazepine level testing; blood tests for liver/kidney function, and electrolyte