Differential Diagnosis for Vertigo with Hearing Loss
- Single most likely diagnosis
- Meniere's disease: This condition is characterized by a group of symptoms, including vertigo, hearing loss, tinnitus, and ear fullness. The symptoms often occur in episodes and can be debilitating. Meniere's disease is a common cause of vertigo associated with hearing loss, making it the single most likely diagnosis.
- Other Likely diagnoses
- Benign Paroxysmal Positional Vertigo (BPPV): Although BPPV primarily causes vertigo, some patients may experience hearing loss, especially if it's related to a head injury or inner ear problems. The vertigo in BPPV is typically triggered by specific head movements.
- Labyrinthitis: This is an inner ear disorder characterized by inflammation of the labyrinth, which can cause vertigo and hearing loss. It often follows a viral infection.
- Vestibular Neuritis: While primarily causing vertigo, some cases of vestibular neuritis may be associated with hearing loss, especially if there's an underlying viral infection affecting both the vestibular and auditory systems.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Stroke or Transient Ischemic Attack (TIA): Although less common, vertigo can be a symptom of a stroke or TIA, especially in the posterior circulation. Hearing loss can also occur, particularly if the stroke affects the auditory pathways. Given the potential for severe consequences, it's crucial not to miss this diagnosis.
- Acoustic Neuroma: A benign tumor growing on the cranial nerve running from the brain to the inner ear, which can cause vertigo, hearing loss, and tinnitus. Early detection is key for effective management.
- Rare diagnoses
- Otosclerosis: A condition in which there is abnormal bone growth in the middle ear, which can cause hearing loss and, less commonly, vertigo.
- 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, often triggered by sound or pressure changes.
- Cogan's Syndrome: A rare disorder characterized by recurrent corneal inflammation and vestibular-auditory symptoms, including vertigo and hearing loss. It can be associated with systemic vasculitis.