Differential Diagnosis for Dizziness and Headaches
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 accompanied by headaches. It's a common cause of dizziness and can be diagnosed with a thorough history and physical examination, including the Dix-Hallpike maneuver.
Other Likely Diagnoses
- Migraine: Migraines can cause dizziness and headaches, often with other symptoms like nausea, vomiting, and sensitivity to light and sound. The headaches are typically unilateral and can be severe.
- Tension-Type Headache: These headaches are common and can cause mild to moderate pain, often accompanied by dizziness or lightheadedness, especially if the headache is severe.
- Inner Ear Infection (Labyrinthitis): Infections of the inner ear can cause dizziness, vertigo, and headaches due to inflammation affecting balance and hearing structures.
- Vestibular Migraine: A condition that causes vertigo, dizziness, and headaches, similar to migraines but with a stronger emphasis on vestibular symptoms.
Do Not Miss Diagnoses
- Subarachnoid Hemorrhage: Although rare, this condition is life-threatening and can present with sudden, severe headache (often described as "the worst headache of my life") and dizziness. Immediate medical attention is required.
- Stroke or Transient Ischemic Attack (TIA): Dizziness and headache can be symptoms of a stroke or TIA, especially if accompanied by other neurological deficits like weakness, numbness, or difficulty with speech.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord can cause headache, dizziness, fever, and stiff neck. It's a medical emergency.
- Temporal Arteritis: This condition involves inflammation of the blood vessels in the head and can cause headaches, dizziness, and visual disturbances. It's more common in older adults and requires prompt treatment to prevent complications like blindness.
Rare Diagnoses
- Multiple Sclerosis: An autoimmune disease that can affect the brain and spinal cord, leading to a wide range of neurological symptoms, including dizziness and headaches.
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which can cause dizziness, balance problems, and headaches, along with hearing loss.
- Chiari Malformation: A structural defect in the cerebellum that controls balance, which can cause dizziness, headaches, and other neurological symptoms, especially with certain head movements.
- Superior Canal Dehiscence: A rare condition where there's an abnormal opening in the bone overlying the superior canal of the inner ear, leading to vertigo, dizziness, and hearing symptoms in response to sound or pressure changes.