Differential Diagnosis for Head Reeling due to Ear Discharge

Single Most Likely Diagnosis

• Benign Paroxysmal Positional Vertigo (BPPV): This condition is often associated with inner ear problems and can cause vertigo, which might be described as a head reeling sensation. Ear discharge could be a secondary symptom or unrelated, but the primary complaint of vertigo points towards BPPV.

Other Likely Diagnoses

• Labyrinthitis: An inner ear infection that can cause dizziness, vertigo, and balance problems, which might be perceived as head reeling. It often presents with ear discharge if there's a middle ear involvement.
• Middle Ear Infection (Otitis Media): While primarily causing pain and discharge, a severe or complicated middle ear infection can lead to labyrinthine involvement, causing vertigo.
• Ménière's Disease: A disorder of the inner ear that affects balance and hearing, leading to episodes of vertigo, which could be described as head reeling. Ear fullness and tinnitus are common, and discharge might be present if there's a secondary infection.

Do Not Miss Diagnoses

• Mastoiditis: A serious infection of the mastoid bone in the skull, which can lead to severe complications if not treated promptly. Symptoms can include ear discharge, vertigo, and signs of systemic infection.
• Cerebellopontine Angle Tumor (e.g., Acoustic Neuroma): Although rare, these tumors can cause vertigo, hearing loss, and ear fullness. Discharge might not be a primary symptom but could occur due to secondary infection or Eustachian tube dysfunction.
• Stroke or Transient Ischemic Attack (TIA): Vertebrobasilar insufficiency can cause vertigo, which might be described as head reeling. While discharge is not typically associated with stroke, it's crucial to rule out given the potential for severe outcomes.

Rare Diagnoses

• Syphilis (Otosyphilis): A rare cause of vertigo and hearing loss, associated with secondary syphilis. Ear discharge could be present in the context of a middle ear infection.
• Relapsing Fever: Caused by certain bacteria, this condition can lead to various symptoms including vertigo and might be associated with ear discharge in some cases, though it's quite rare.
• Autoimmune Inner Ear Disease: A rare condition that can cause vertigo, hearing loss, and sometimes ear fullness or discharge, depending on the extent of inner ear involvement.