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Vertigo is typically classified into one of two categories depending on the location of the damaged vestibular pathway. These are peripheral or central vertigo. Each category has a distinct set of characteristics and associated findings.
Peripheral vertigo: The lesions, or the damaged areas, affect the inner ear or the vestibular division of the acoustic (CN VIII) nerve. Vertigo that is peripheral in origin tends to be felt as more severe than central vertigo, intermittent in timing, always associated with nystagmus in the horizontal plane and occasionally hearing loss or tinnitus (ringing of the ears).

Peripheral vertigo can be caused by BPPV, Ménière's disease or acute vestibular neuronitis. Peripheral vertigo, compared to the central type, though subjectively felt as more severe, is usually from a less serious cause.

Central vertigo: The lesions in central vertigo involve the brainstem vestibular nerve nuclei. Central vertigo is typically described as constant in timing, less severe in nature and occasionally with nystagmus that can be multi-directional.