Dizzy Differential Diagnosis
The differential diagnosis for dizziness is broad and can be categorized into several groups based on the likelihood and potential impact of missing a diagnosis.
Single most likely diagnosis:
- Benign Paroxysmal Positional Vertigo (BPPV) - This is often the most common cause of vertigo, which is a type of dizziness characterized by the sensation of spinning. It is related to the movement of the head and is usually harmless but can be very uncomfortable.
Other Likely diagnoses:
- Vestibular Migraine - A condition that involves vertigo, often accompanied by migraine headaches, but can occur without headache. It's a common cause of dizziness in the general population.
- Labyrinthitis - An inner ear disorder characterized by the inflammation of the part of the inner ear responsible for balance (labyrinth). It can cause severe dizziness, vertigo, and balance problems.
- Medication-induced dizziness - Many medications can cause dizziness as a side effect, including antihistamines, antidepressants, and blood pressure medications.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Stroke or Transient Ischemic Attack (TIA) - Although less common, dizziness can be a symptom of a stroke or TIA, especially when accompanied by other neurological deficits. Early recognition is crucial for timely intervention.
- Posterior Circulation Stroke - A specific type of stroke that can present with vertigo, among other symptoms, and requires immediate medical attention.
- Cardiac causes (e.g., arrhythmias, cardiac tamponade) - Certain heart conditions can lead to reduced blood flow to the brain, causing dizziness. These conditions are medical emergencies.
Rare diagnoses:
- Meniere's Disease - A disorder of the inner ear that affects balance and hearing, leading to episodes of vertigo, tinnitus, hearing loss, and ear fullness.
- Acoustic Neuroma - A non-cancerous tumor on the nerve connecting the inner ear to the brain, which can cause dizziness, hearing loss, and balance problems.
- Multiple Sclerosis - An autoimmune disease that can affect the brain and spinal cord, leading to a wide range of symptoms, including dizziness and vertigo, although it's less common as a presenting symptom.