Differential Diagnosis for a 2-year-old with Dizziness
Single Most Likely Diagnosis
- Benign Paroxysmal Vertigo (BPV): This condition is common in children around the age of 2 and is characterized by brief episodes of vertigo, often triggered by changes in head position. It's usually self-limiting and resolves without specific treatment.
Other Likely Diagnoses
- Viral Labyrinthitis: An inner ear infection that can cause dizziness, nausea, and vomiting. It's often preceded by a viral upper respiratory infection.
- Otitis Media: Middle ear infection, which can cause dizziness due to the proximity of the middle ear to the vestibular system.
- Inner Ear Infection: Such as labyrinthitis or vestibular neuritis, which can cause dizziness and balance problems.
Do Not Miss Diagnoses
- Meningitis: Although less common, meningitis is a life-threatening condition that can present with dizziness, along with other symptoms like fever, headache, and stiff neck. Early diagnosis and treatment are crucial.
- Traumatic Brain Injury: Especially if there's a history of recent head trauma, which could lead to conditions like a concussion or more severe brain injuries.
- Posterior Circulation Stroke: Though rare in children, a stroke can cause sudden onset of dizziness, among other neurological deficits.
Rare Diagnoses
- Congenital Inner Ear Anomalies: Conditions like a Mondini dysplasia can cause balance and hearing problems, presenting as dizziness in young children.
- Chiari Malformation: A structural defect in the cerebellum that can cause dizziness, among other neurological symptoms, due to the compression of the cerebellum and brainstem.
- Autoimmune Inner Ear Disease: A rare condition where the immune system attacks the inner ear, leading to dizziness, hearing loss, and sometimes tinnitus.