Differential Diagnosis for Vertigo Lasting Over a Month
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, episodic vertigo triggered by specific head movements. It's a common cause of vertigo and can persist for more than a month if not treated.
Other Likely Diagnoses
- Vestibular Migraine: A condition where vertigo is a prominent symptom, often accompanied by headache, sensitivity to light and sound, and sometimes, visual auras. It can cause prolonged vertigo.
- Meniere's Disease: An inner ear disorder that involves vertigo, tinnitus, hearing loss, and ear fullness. Episodes can last from minutes to hours and can occur frequently over months.
- Labyrinthitis: Inflammation of the inner ear, which can cause vertigo, hearing loss, and tinnitus. The duration of symptoms can vary and may last over a month.
Do Not Miss Diagnoses
- Posterior Circulation Stroke or Transient Ischemic Attack (TIA): Although less common, vertigo can be a presenting symptom of a stroke or TIA, especially if accompanied by other neurological deficits. Early diagnosis is crucial for treatment and prevention of further events.
- Multiple Sclerosis: An autoimmune disease that can affect the brain and spinal cord, leading to a wide range of neurological symptoms, including vertigo. It's essential to consider this diagnosis to initiate appropriate treatment.
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which can cause vertigo, hearing loss, and tinnitus. Early detection is important for treatment planning.
Rare Diagnoses
- Mal de Debarquement Syndrome: A rare condition where vertigo persists after exposure to motion (like a boat ride) and can last for months.
- Perilymphatic Fistula: An abnormal connection between the inner and middle ear, leading to vertigo, hearing loss, and tinnitus. It's a rare cause of vertigo but should be considered in the appropriate clinical context.
- Autoimmune Inner Ear Disease: A rare condition where the immune system attacks the inner ear, leading to vertigo, hearing loss, and sometimes, tinnitus. It's essential to diagnose this condition to start immunosuppressive treatment.