Differential Diagnosis for Dizziness, Tinnitus, and Hearing Loss
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 also cause tinnitus and hearing loss. It's a common cause of vertigo and has a strong association with the symptoms described.
Other Likely Diagnoses
- Meniere's Disease: An inner ear disorder that involves the inner ear's balance (vestibular) and hearing systems, leading to episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear. The combination of these symptoms makes Meniere's a likely consideration.
- Labyrinthitis: An inner ear infection that can cause dizziness, hearing loss, and tinnitus. It often follows a viral upper respiratory infection and can lead to significant morbidity if not properly treated.
- Vestibular Migraine: A condition that can cause vertigo, tinnitus, and sometimes hearing loss, often accompanied by migraine headaches. The symptoms can be episodic and may be triggered by specific factors.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less common, stroke or TIA can present with sudden onset of dizziness, tinnitus, and hearing loss, especially if the brainstem or cerebellum is involved. 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, tinnitus, and balance problems. Early detection is crucial for effective management.
- Multiple Sclerosis: An autoimmune disease that can affect various parts of the brain and spinal cord, leading to a wide range of symptoms, including dizziness, hearing loss, and tinnitus. It's essential to consider this diagnosis to initiate appropriate treatment.
Rare Diagnoses
- Ototoxicity: Certain medications or chemicals can damage the inner ear, leading to hearing loss, tinnitus, and dizziness. This is a rare cause but should be considered, especially in patients with a history of exposure to such substances.
- Superior Semicircular Canal Dehiscence: A rare condition where there is an abnormal opening in the bone overlying the superior semicircular canal, leading to vertigo, hearing loss, and autophony (hearing internal sounds unusually loudly). It's a rare cause of the symptoms but can be diagnosed with specific imaging tests.
- Cogan Syndrome: A rare disorder characterized by recurrent corneal inflammation and vestibular-auditory symptoms, including hearing loss, tinnitus, and vertigo. It's essential to consider this diagnosis in patients with eye symptoms in addition to the described auditory and vestibular symptoms.