Differential Diagnosis for Mild Labyrinthitis with Vertigo when Looking to the Left
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, intense episodes of vertigo triggered by specific head movements, such as looking to the left in this case. It is the most common cause of vertigo and often associated with labyrinthitis.
Other Likely Diagnoses
- Vestibular Neuritis: An inflammation of the vestibular nerve, which can cause vertigo that may be exacerbated by certain head movements. It's a common cause of vertigo and could be related to labyrinthitis.
- Labyrinthine Concussion: If there's a history of head trauma, a labyrinthine concussion could be a cause, leading to symptoms similar to labyrinthitis, including vertigo triggered by movement.
- Meniere's Disease: Although it typically presents with a combination of vertigo, hearing loss, tinnitus, and ear fullness, early stages or mild cases might only exhibit vertigo, especially with specific movements.
Do Not Miss Diagnoses
- Posterior Circulation Stroke: Although less likely, a stroke in the posterior circulation (including the vertebrobasilar system) can present with isolated vertigo. Given the potentially devastating consequences of missing a stroke, it's crucial to consider and rule out this diagnosis.
- Multiple Sclerosis: In rare cases, multiple sclerosis can present with vertigo as an initial symptom, especially if there's involvement of the brainstem or cerebellum.
Rare Diagnoses
- Perilymph Fistula: A rare condition where there's an abnormal connection between the inner and middle ear, leading to vertigo and potentially triggered by changes in pressure or certain movements.
- Superior Semicircular Canal Dehiscence: A rare condition where there's an abnormal opening in the bone overlying the superior semicircular canal, which can cause vertigo triggered by sound or pressure changes, and potentially by specific head movements.