Differential Diagnosis for Severe Dizziness, Nausea, and Fatigue
Single Most Likely Diagnosis
- Vestibular Neuritis or Labyrinthitis: This condition is characterized by inflammation of the inner ear, leading to severe dizziness (vertigo), nausea, and fatigue. It is a common cause of these symptoms and often follows a viral infection.
Other Likely Diagnoses
- Benign Paroxysmal Positional Vertigo (BPPV): A condition related to the inner ear where small crystals become dislodged and cause brief but intense episodes of vertigo, often accompanied by nausea and fatigue.
- Inner Ear Infection: Infections such as otitis media or otitis interna can cause dizziness, nausea, and fatigue due to the involvement of the vestibular system.
- Migraine-associated Vertigo: Some patients with migraines can experience vertigo, nausea, and fatigue as part of their migraine symptoms.
- Anxiety or Panic Disorder: Severe anxiety or panic attacks can manifest with dizziness, nausea, and fatigue, among other symptoms.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less common, a stroke or TIA can present with sudden onset of dizziness, nausea, and fatigue, especially if accompanied by other neurological deficits. Missing this diagnosis could be catastrophic.
- Multiple Sclerosis: An initial episode of multiple sclerosis can present with vertigo, nausea, and fatigue, among other neurological symptoms.
- Cardiac Conditions (e.g., Arrhythmias, Heart Failure): Certain cardiac conditions can lead to decreased blood flow to the brain, resulting in dizziness, nausea, and fatigue.
- Medication Side Effects: Various medications can cause dizziness, nausea, and fatigue as side effects, and it's crucial to consider the patient's medication list.
Rare Diagnoses
- Meniere's Disease: A disorder of the inner ear that affects balance and hearing, leading to episodes of vertigo, nausea, and fatigue, but it typically includes hearing loss and tinnitus.
- Acoustic Neuroma: A rare tumor on the nerve connecting the inner ear to the brain, which can cause dizziness, nausea, and fatigue, along with hearing loss and tinnitus.
- Mal de Debarquement Syndrome: A rare condition that occurs after a journey by boat, plane, or car, leading to a persistent feeling of swaying or rocking, accompanied by nausea and fatigue.