Differential Diagnosis for Vertigo and Dizziness
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is a common cause of vertigo, especially after a change in environment or travel, which could involve air travel or other forms of transportation that might precipitate or exacerbate symptoms. The recent return from a study abroad trip could be a contributing factor due to the potential for changes in sleep patterns, stress, or even minor head injuries during travel.
Other Likely Diagnoses
- Vestibular Migraine: Given the recent travel and potential changes in sleep patterns, stress levels, or exposure to new environments, vestibular migraine is a plausible diagnosis. It can cause vertigo and dizziness without the headache phase.
- Labyrinthitis: An inner ear infection that could be contracted during travel, especially if the individual was exposed to others who were sick. It can cause vertigo, dizziness, and sometimes hearing loss.
- Middle Ear Problems: Issues such as a middle ear infection or Eustachian tube dysfunction could lead to vertigo and dizziness, especially if the individual experienced barotrauma during flights.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less common, vertigo can be a presenting symptom of a stroke or TIA, especially in the posterior circulation. It's crucial to rule out these conditions due to their high morbidity and mortality.
- Multiple Sclerosis: While less likely, an initial presentation of multiple sclerosis could include vertigo and dizziness among other neurological symptoms.
- Posterior Circulation Infarct: Similar to stroke, an infarct in the posterior circulation can present with vertigo and should be considered due to its potential severity.
Rare Diagnoses
- Meniere's Disease: An inner ear disorder that involves vertigo, but it typically includes hearing loss and tinnitus, which might not be present in this case.
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which could cause vertigo among other symptoms like hearing loss.
- Mal de Débarquement Syndrome: A rare condition that some people experience after a cruise or boat travel, characterized by a feeling of swaying or imbalance after returning to land.