What are the key differences between Visual Vertigo, Persistent Postural Perceptual Dizziness (PPPD) and Postural Phobic Vertigo (PPV)?

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Differential Diagnosis for Visual Vertigo vs PPD vs PPV

Single Most Likely Diagnosis

  • Visual Vertigo: This is the most likely diagnosis if the patient's symptoms are triggered by visual stimuli, such as patterns, crowds, or complex environments, and are characterized by a sense of spinning or imbalance.
  • PPV (Postural Phobic Vertigo): This could be considered the most likely diagnosis if the patient's symptoms are primarily related to a fear of falling or a phobic response to certain postures or movements, leading to vertigo and imbalance.

Other Likely Diagnoses

  • PPD (Phobic Postural Vertigo): Similar to PPV, PPD is characterized by a phobic response to certain postures or movements, but it may not necessarily involve a fear of falling. Symptoms can include vertigo, imbalance, and anxiety.
  • Benign Paroxysmal Positional Vertigo (BPPV): Although BPPV is typically characterized by brief, episodic vertigo triggered by specific head movements, some patients may experience more prolonged symptoms that could be confused with visual vertigo or PPV.

Do Not Miss Diagnoses

  • Vestibular Migraine: This condition can cause vertigo, headache, and sensitivity to visual stimuli, making it a crucial diagnosis to consider, as missing it could lead to inadequate treatment and ongoing symptoms.
  • Stroke or Transient Ischemic Attack (TIA): Although less common, vertigo can be a symptom of a stroke or TIA, particularly if accompanied by other neurological symptoms such as weakness, numbness, or difficulty with speech.
  • Multiple Sclerosis: In some cases, vertigo can be a presenting symptom of multiple sclerosis, especially if accompanied by other neurological symptoms such as optic neuritis, weakness, or numbness.

Rare Diagnoses

  • Mal de Debarquement Syndrome: A rare condition characterized by a persistent sense of swaying or rocking after exposure to motion, such as a boat ride.
  • Superior Canal Dehiscence: A rare condition where there is an abnormal opening in the bone overlying the superior canal of the inner ear, leading to vertigo and sound-induced symptoms.
  • Vestibular Paroxysmia: A rare condition characterized by brief, episodic vertigo attacks, often triggered by specific movements or sounds.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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