Differential Diagnosis for Dizziness with Bending Forward
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, intense episodes of vertigo triggered by specific head movements, such as bending forward. It is the most common cause of vertigo and has a strong association with positional changes.
Other Likely Diagnoses
- Orthostatic Hypotension: This condition involves a significant drop in blood pressure upon standing, which can also be triggered by bending forward, leading to dizziness. It's common in patients with dehydration, blood loss, or certain medications.
- Vestibular Migraine: Although not exclusively triggered by bending forward, vestibular migraines can cause vertigo and dizziness that may be exacerbated by positional changes.
- Inner Ear Infection (Labyrinthitis): Infections of the inner ear can cause dizziness and vertigo, which might worsen with movement, including bending forward.
Do Not Miss Diagnoses
- Subclavian Steal Syndrome: A rare condition where the subclavian artery is narrowed or blocked, leading to reversal of blood flow in the vertebral artery. It can cause dizziness, especially with arm exercise or certain positions, including bending forward.
- Vertebral Artery Dissection or Stroke: Although less common, bending forward can sometimes precipitate or worsen symptoms of a vertebral artery dissection or stroke, leading to dizziness among other neurological deficits.
- Cardiac Causes (e.g., Aortic Stenosis, Cardiac Arrhythmias): Certain cardiac conditions can lead to dizziness upon exertion or positional changes due to decreased cardiac output or arrhythmias.
Rare Diagnoses
- Chiari Malformation: A structural defect in the cerebellum that controls balance, which can cause dizziness that worsens with coughing, sneezing, or bending forward due to increased intracranial pressure.
- Superior Canal Dehiscence: A rare condition where there is an abnormal opening in the bone overlying the superior canal of the inner ear, leading to vertigo and dizziness triggered by sound or pressure changes, including those caused by bending forward.