Differential Diagnosis for Vertigo
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This is the most common cause of vertigo, characterized by brief, episodic vertigo triggered by specific head movements. It is often related to the movement of otolith crystals in the inner ear.
Other Likely Diagnoses
- Vestibular Migraine: A condition where vertigo is associated with migraine headaches, often without the headache itself being present. It's a common cause of vertigo, especially in patients with a history of migraines.
- Meniere's Disease: A disorder of the inner ear that affects balance and hearing, leading to episodes of vertigo, tinnitus, hearing loss, and ear fullness.
- Labyrinthitis: An inner ear disorder characterized by inflammation of the labyrinth, which can cause vertigo, hearing loss, and tinnitus.
- Acute Vestibular Neuritis: Inflammation of the vestibular nerve, leading to sudden onset of vertigo, often without hearing loss.
Do Not Miss Diagnoses
- Posterior Circulation Stroke: Although less common, a stroke in the posterior circulation can present with vertigo, and missing this diagnosis can be catastrophic. It requires immediate medical attention.
- Multiple Sclerosis: In rare cases, vertigo can be a presenting symptom of multiple sclerosis, an autoimmune disease affecting the central nervous system.
- Vertebrobasilar Insufficiency: A condition where the blood flow in the posterior circulation of the brain is compromised, leading to symptoms like vertigo, which can precede a stroke.
Rare Diagnoses
- 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 symptoms.
- Perilymphatic Fistula: An abnormal connection between the inner and middle ear, causing vertigo, hearing loss, and other symptoms.
- Chiari Malformation: A structural defect in the cerebellum that can cause vertigo among other neurological symptoms, due to the compression of the cerebellum and brainstem.