Differential Diagnosis for Vertigo Preceded by Migraine
Single Most Likely Diagnosis
- Vestibular Migraine: This condition is characterized by episodic vertigo that can be triggered by migraine headaches. The vertigo can occur with or without the headache, and the patient's history of migraine 2 weeks prior to the onset of vertigo supports this diagnosis.
Other Likely Diagnoses
- Benign Paroxysmal Positional Vertigo (BPPV): Although BPPV is not directly related to migraines, it is a common cause of vertigo and can occur in anyone, including those with a history of migraines.
- Meniere's Disease: This inner ear disorder can cause vertigo, tinnitus, and hearing loss. While it is not directly linked to migraines, some patients with Meniere's may experience migraine-like symptoms.
- Labyrinthitis: Inflammation of the inner ear can cause vertigo, and some cases may be preceded by a viral infection or migraine-like symptoms.
Do Not Miss Diagnoses
- Posterior Circulation Stroke: Although less common, a stroke in the posterior circulation can cause vertigo, and a history of migraine may sometimes be mistaken for a stroke. It is crucial to rule out this diagnosis due to its severe consequences.
- Multiple Sclerosis: In rare cases, multiple sclerosis can present with vertigo, and some patients may experience migraine-like symptoms. Early diagnosis is essential for effective management.
- Acoustic Neuroma: A benign tumor on the vestibulocochlear nerve can cause vertigo, tinnitus, and hearing loss. While rare, it is essential to consider this diagnosis to ensure timely treatment.
Rare Diagnoses
- Vestibular Paroxysmia: A rare condition characterized by brief episodes of vertigo, often related to a vascular compression of the vestibulocochlear nerve.
- Cervicogenic Vertigo: Vertigo caused by cervical spine disorders, which can be mistaken for other conditions, including migraines.
- Autoimmune Inner Ear Disease: A rare condition where the immune system attacks the inner ear, causing vertigo, hearing loss, and other symptoms.