Differential Diagnosis for Neck Pain and Vertigo

The patient presents with neck pain and vertigo, along with a history of similar symptoms and a family history of Chiari malformation. The following differential diagnoses are considered:

• Single Most Likely Diagnosis
  • Cervicogenic Vertigo: This condition is characterized by vertigo caused by neck pain or movement, which aligns with the patient's symptoms. The patient's history of right-sided neck pain causing vertigo and the current presentation of neck pain with vertigo support this diagnosis.
• Other Likely Diagnoses
  • Benign Paroxysmal Positional Vertigo (BPPV): The patient's symptoms of positional dizziness and vertigo are consistent with BPPV, although the presence of neck pain is not typical.
  • Cervical Spondylosis: This condition can cause neck pain and vertigo, especially in older adults, although the patient's age is not specified.
  • Migraine-Associated Vertigo: The patient's symptoms of headache and vertigo could be related to migraines, which can cause vertigo.
• Do Not Miss Diagnoses
  • Vertebral Artery Dissection: This is a potentially life-threatening condition that can cause neck pain and vertigo. Although it is less likely, it is crucial to consider due to its severity.
  • Chiari Malformation: Given the patient's family history of Chiari malformation, it is essential to consider this diagnosis, especially if the patient's symptoms worsen or if the neck MRI shows any abnormalities.
  • Multiple Sclerosis: This condition can cause vertigo, neck pain, and other neurological symptoms, although it is less likely without other supporting symptoms.
• Rare Diagnoses
  • Vestibular Schwannoma: This is a rare tumor that can cause vertigo, hearing loss, and other symptoms, although it is unlikely without other supporting symptoms.
  • Ehlers-Danlos Syndrome: This condition can cause joint hypermobility, neck pain, and vertigo, although it is rare and would require further evaluation to confirm.