Differential Diagnosis for Hearing Loss and Vertigo
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, episodic vertigo triggered by specific head movements, and it can be associated with hearing loss, especially if it coexists with other inner ear disorders. Its high prevalence and the specific nature of the symptoms make it a leading consideration.
Other Likely Diagnoses
- Meniere's Disease: A disorder of the inner ear that affects balance and hearing, causing vertigo, tinnitus, hearing loss, and ear fullness. The combination of hearing loss and vertigo is a hallmark of this condition.
- Labyrinthitis: An inner ear disorder characterized by inflammation of the part of the inner ear responsible for balance (labyrinth), which can lead to vertigo and hearing loss.
- Vestibular Neuritis: Inflammation of the vestibular nerve, which can cause severe vertigo, and if the auditory nerve is also affected, hearing loss may occur.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less common, a stroke or TIA affecting the brainstem or cerebellum can present with sudden onset of vertigo and hearing loss. Missing this diagnosis could be catastrophic.
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which can cause hearing loss and vertigo due to its location and potential to compress adjacent structures.
- Multiple Sclerosis: An autoimmune disease that can affect various parts of the brain and spinal cord, including areas responsible for hearing and balance, leading to a wide range of symptoms including vertigo and hearing loss.
Rare Diagnoses
- Superior Semicircular Canal Dehiscence: A rare condition where there is an abnormal opening in the bone overlying the superior semicircular canal, leading to vertigo and hearing loss due to sound and pressure-induced vertigo.
- Cogan Syndrome: A rare disorder characterized by recurrent corneal inflammation and vestibular-auditory symptoms, including hearing loss and vertigo.
- Ototoxicity: Certain medications and chemicals can damage the inner ear, leading to hearing loss and vertigo. This is a rare cause but important to consider in patients with a history of exposure to such substances.