Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, episodic vertigo triggered by specific head movements, and it can sometimes be accompanied by facial numbness due to referred symptoms or associated conditions. Its high prevalence among dizzy patients makes it a likely initial consideration.

Multiple Sclerosis (MS): MS can present with a wide range of neurological symptoms, including dizziness and facial numbness, due to demyelinating lesions in the central nervous system. The optic neuritis, internuclear ophthalmoplegia, and other brainstem or spinal cord symptoms can sometimes accompany these symptoms.
Migraine: Migraines can cause dizziness (vertigo) and facial numbness as part of their aura or as a migraine equivalent. The presence of headache, photophobia, or phonophobia can help in diagnosing migraines.
Vestibular Migraine: A subtype of migraine that predominantly features vertigo, which can be accompanied by facial numbness or other neurological symptoms, making it a consideration in patients with these complaints.

Stroke or Transient Ischemic Attack (TIA): Although less common, stroke or TIA can present with sudden onset dizziness and facial numbness. The posterior circulation strokes, in particular, can cause vertigo and may be accompanied by other symptoms like dysarthria, diplopia, or ataxia. Missing this diagnosis can be catastrophic.
Acoustic Neuroma: A benign tumor on the eighth cranial nerve can cause dizziness, facial numbness, hearing loss, and tinnitus. Early diagnosis is crucial for effective management and preventing further complications.
Multiple Cranial Neuropathies: Conditions like Miller Fisher syndrome, a variant of Guillain-Barré syndrome, can present with ophthalmoplegia, ataxia, and areflexia, and sometimes facial numbness and dizziness, making prompt recognition critical.

Neurosyphilis: This condition can manifest in various ways, including with symptoms of dizziness and facial numbness, particularly in the tertiary stage. Its rarity and nonspecific symptoms make it easy to overlook but important to consider in high-risk populations or when other diagnoses are ruled out.
Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like episodes (MELAS): A rare mitochondrial disorder that can cause stroke-like episodes, including symptoms like dizziness and facial numbness, along with other systemic features.
Cerebellopontine Angle (CPA) Tumors: Besides acoustic neuromas, other tumors in the CPA can cause similar symptoms due to compression of cranial nerves and the brainstem, though they are less common.