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Differential Diagnosis for Vertigo with Nausea

Single Most Likely Diagnosis

  • Benign Paroxysmal Positional Vertigo (BPPV): This condition is the most common cause of vertigo and is characterized by brief, episodic vertigo triggered by specific head movements. The association with nausea is common, and it often resolves on its own or with simple maneuvers like the Epley maneuver.

Other Likely Diagnoses

  • Vestibular Migraine: A condition that involves vertigo, often accompanied by nausea and sometimes headache, but not necessarily. It's a common cause of vertigo in patients with a history of migraines.
  • Labyrinthitis: An inner ear disorder characterized by inflammation of the labyrinth, which can cause vertigo, nausea, and sometimes hearing loss. It often follows a viral infection.
  • Meniere's Disease: A disorder of the inner ear that causes episodes of vertigo, ringing in the ears (tinnitus), hearing loss, and a feeling of fullness in the ear. Nausea can accompany vertigo episodes.

Do Not Miss Diagnoses

  • Stroke or Transient Ischemic Attack (TIA): Although less common, vertigo can be a symptom of a stroke or TIA, especially if accompanied by other neurological deficits. It's crucial to rule out these conditions due to their high morbidity and mortality.
  • Posterior Circulation Stroke: Specifically, strokes affecting the cerebellum or brainstem can cause vertigo, nausea, and vomiting, along with other neurological signs.
  • Multiple Sclerosis: In rare cases, vertigo can be a presenting symptom of multiple sclerosis, especially if accompanied by other neurological symptoms.

Rare Diagnoses

  • Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which can cause vertigo, hearing loss, and tinnitus.
  • Superior Semicircular Canal Dehiscence: A rare condition where there's an abnormal opening in the bone overlying the superior semicircular canal, leading to vertigo and autophony (hearing internal sounds unusually loudly).
  • Perilymphatic Fistula: An abnormal connection between the inner and middle ear, causing vertigo, hearing loss, and sometimes nausea, often related to trauma, surgery, or barotrauma.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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