Differential Diagnosis for Dizziness when Looking Up

Single most likely diagnosis

• Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, episodic vertigo triggered by specific head movements, such as looking up. The symptoms described, including the frequency and specific trigger, align closely with BPPV.

Other Likely diagnoses

• Cervicogenic Dizziness: This condition involves dizziness caused by neck movement or tension, which could be exacerbated by looking up. Given the mechanical nature of the trigger, it's a plausible explanation.
• Vestibular Migraine: Although typically associated with headache, vestibular migraines can cause episodic vertigo without headache. The periodic nature of the symptoms could fit this diagnosis.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)

• Vertebral Artery Dissection: A rare but potentially life-threatening condition where a tear in the vertebral artery can lead to stroke. Although unlikely, any form of vertigo or dizziness warrants consideration of vascular causes due to the potential for severe consequences.
• Posterior Circulation Stroke: Strokes in the posterior circulation can present with vertigo among other symptoms. Early recognition is crucial for effective treatment.

Rare diagnoses

• Chiari Malformation: A structural defect in the cerebellum that can cause a range of symptoms, including dizziness triggered by certain positions or movements. It's less common but could be considered if other diagnoses are ruled out.
• Superior Canal Dehiscence: A rare condition where there's an abnormal opening in the bone overlying the superior canal of the inner ear, leading to vertigo triggered by sound or pressure changes, which might include the act of looking up in some cases.