Differential Diagnosis for Unexplained Dizziness
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is a common cause of dizziness, especially in older adults. It occurs when small crystals in the inner ear become dislodged and cause brief but intense episodes of vertigo.
Other Likely Diagnoses
- Vestibular Migraine: A condition characterized by recurrent episodes of vertigo, often accompanied by headache, sensitivity to light and sound, and nausea. It's a common cause of dizziness in patients with a history of migraines.
- Labyrinthitis: An inner ear disorder that involves inflammation of the labyrinth, leading to dizziness, hearing loss, and balance problems.
- Medication Side Effects: Various medications, such as sedatives, antidepressants, and blood pressure medications, can cause dizziness as a side effect.
- Anxiety Disorders: Conditions like anxiety and panic disorders can manifest with symptoms of dizziness, lightheadedness, and unsteadiness.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less common, a stroke or TIA can present with sudden onset of dizziness, and it's crucial to rule out these conditions due to their high morbidity and mortality.
- Cardiac Arrhythmias: Abnormal heart rhythms, such as atrial fibrillation, can cause dizziness due to reduced cardiac output.
- Hypertensive Crisis: A sudden and severe increase in blood pressure can lead to dizziness, headache, and visual disturbances.
- Multiple Sclerosis: A demyelinating disease that can cause dizziness, vertigo, and balance problems, especially in young adults.
Rare Diagnoses
- Meniere's Disease: A disorder of the inner ear that affects balance and hearing, causing episodes of vertigo, tinnitus, and hearing loss.
- Acoustic Neuroma: A rare, benign tumor that grows on the nerve connecting the inner ear to the brain, leading to dizziness, hearing loss, and balance problems.
- Mal de Debarquement Syndrome: A rare condition that occurs after a period of exposure to motion, such as a boat ride, causing persistent dizziness and balance problems.