What are the neurological differential diagnoses for vertigo?

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Differential Diagnosis for Vertigo

Single Most Likely Diagnosis

  • Benign Paroxysmal Positional Vertigo (BPPV): This is the most common cause of vertigo, characterized by brief, episodic vertigo triggered by specific head movements. It is often related to the movement of otolith crystals in the inner ear.

Other Likely Diagnoses

  • Vestibular Migraine: A condition where vertigo is associated with migraine headaches, often accompanied by other symptoms like headache, sensitivity to light and sound, and visual auras.
  • Labyrinthitis: An inner ear disorder characterized by inflammation of the labyrinth, which can cause vertigo, hearing loss, and tinnitus.
  • Meniere's Disease: A disorder of the inner ear that affects balance and hearing, causing episodes of vertigo, tinnitus, hearing loss, and ear fullness.

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 like weakness, numbness, or difficulty with speech.
  • Posterior Circulation Stroke: A stroke affecting the posterior circulation can present with vertigo, along with other symptoms like difficulty with coordination, vision changes, or weakness.
  • Multiple Sclerosis: An autoimmune disease that can cause vertigo among other neurological symptoms, due to demyelination in the central nervous system.

Rare Diagnoses

  • Acoustic Neuroma: A rare, benign tumor on the nerve connecting the inner ear to the brain, which can cause vertigo, hearing loss, and tinnitus.
  • Chiari Malformation: A structural defect in the cerebellum that can cause vertigo, among other symptoms like headache, neck pain, and neurological deficits, due to compression of the brainstem and cerebellum.
  • Superior Canal Dehiscence: A rare condition where there is an abnormal opening in the bone overlying the superior canal of the inner ear, leading to vertigo and hearing symptoms in response to sound or pressure changes.

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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