The vestibular reflex arc contains at least seven neurons and probably many others not yet recognized. The involvement of any one of them may produce vertigo. The lesion may be in the nuclei in either the afferent or the efferent pathway, and the type of vertigo may vary with the location of the lesion. The nearer the lesion to the labyrinth, the nearer the vertigo approaches the true labyrinthine type.
Vertigo is described by the patient as giddiness, dizziness, swimming in the head, staggering or unsteadiness in motion. Many patients with some or all of these symptoms on careful analysis of their complaints will be found to have been describing the dizziness that accompanies an acute gastro-intestinal upset, the weakness resulting from an acute illness or a prolonged chronic suppuration or a long list of possible sensations that do not conform to the type of vertigo under consideration.
MCMURRAY JB. CLINICAL CASES IN WHICH VERTIGO IS A CARDINAL SYMPTOM. Arch Otolaryngol. 1935;22(3):277–284. doi:10.1001/archotol.1935.00640030291001