Differential Diagnosis for Dizziness
Single most likely diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is a common cause of dizziness, especially in older adults, and is characterized by brief, episodic vertigo triggered by specific head movements. Its high prevalence and the fact that it often presents with dizziness make it a likely candidate.
Other Likely diagnoses
- Vestibular Migraine: A condition that can cause episodic vertigo, often accompanied by headache, sensitivity to light and sound, and sometimes, visual auras. Its relatively high frequency among patients with dizziness and its episodic nature make it a plausible diagnosis.
- Labyrinthitis: An inner ear disorder characterized by inflammation of the labyrinth, which can cause severe dizziness, hearing loss, and sometimes, tinnitus. The combination of vertigo with auditory symptoms suggests this diagnosis.
- Medication-induced Dizziness: Various medications, including antihypertensives, sedatives, and antidepressants, can cause dizziness as a side effect. Given the wide use of these medications, this is a common cause of dizziness.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Stroke or Transient Ischemic Attack (TIA): Although less common than other causes of dizziness, stroke or TIA can present with sudden onset of vertigo and is a medical emergency. Missing this diagnosis could be catastrophic.
- Posterior Circulation Stroke: Specifically, vertebral or basilar artery strokes can cause dizziness among other symptoms like double vision, weakness, and difficulty speaking.
- Cardiac Causes (e.g., Arrhythmias, Cardiac Valve Problems): Conditions like atrial fibrillation can lead to reduced cardiac output, resulting in dizziness. These conditions require prompt diagnosis and treatment.
Rare diagnoses
- Meniere's Disease: A disorder of the inner ear that causes episodes of vertigo, ringing in the ears (tinnitus), hearing loss, and a feeling of fullness in the ear. It's less common than other causes of dizziness but should be considered in patients with a combination of these symptoms.
- Acoustic Neuroma: A non-cancerous tumor on the nerve connecting the inner ear to the brain, which can cause dizziness, hearing loss, and tinnitus. It's rare but important to diagnose due to its potential impact on hearing and balance.
- Multiple Sclerosis: An autoimmune disease that can affect various parts of the brain and spinal cord, leading to a wide range of symptoms, including dizziness. Although rare as a primary cause of dizziness, its diagnosis is crucial for long-term management.