Differential Diagnosis for Dizziness with Looking Up
- 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 up. The symptoms are due to the movement of otolith crystals in the inner ear.
- Other Likely diagnoses
- Cervicogenic Dizziness: This refers to dizziness that originates from the cervical spine. Looking up can exacerbate the condition by putting strain on the neck and affecting blood flow or nerve signals.
- Vestibular Migraine: Although not exclusively triggered by looking up, vestibular migraines can cause vertigo and dizziness. Certain head movements might exacerbate symptoms in susceptible individuals.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Vertebral Artery Dissection: A tear in the vertebral artery can lead to stroke. Certain head movements, including looking up, might precipitate or worsen symptoms due to mechanical stress on the artery.
- Posterior Circulation Stroke: Strokes affecting the posterior circulation can present with vertigo, among other symptoms. While looking up might not directly cause a stroke, neglecting to investigate sudden onset vertigo could delay diagnosis of a potentially life-threatening condition.
- Rare diagnoses
- Chiari Malformation: A structural defect in the cerebellum that controls balance can cause dizziness, especially with certain head movements. However, this is a less common cause of dizziness with looking up compared to other diagnoses.
- Superior Canal Dehiscence: A rare condition where there is an abnormal opening in the bone overlying the superior canal of the inner ear. It can cause vertigo triggered by sound or pressure changes, including possibly certain head movements.