Differential Diagnosis for Persistent Dizziness
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, episodic vertigo spells triggered by specific head movements. However, some patients may experience persistent dizziness. It's a common cause of vertigo and can be diagnosed with the Dix-Hallpike maneuver.
Other Likely Diagnoses
- Vestibular Migraine: A condition that involves vertigo, often accompanied by headache, sensitivity to light and sound, and sometimes visual auras. It's a common cause of persistent dizziness in patients with a history of migraines.
- Meniere's Disease: An inner ear disorder that involves vertigo, tinnitus, hearing loss, and ear fullness. Episodes can be unpredictable and may lead to persistent dizziness between episodes.
- Labyrinthitis: Inflammation of the inner ear, which can cause persistent dizziness, vertigo, and hearing loss. It often follows a viral infection.
- Medication Side Effects: Certain medications, such as sedatives, antidepressants, and antihistamines, can cause dizziness as a side effect.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less common, dizziness can be a presenting symptom of a stroke or TIA, especially if accompanied by other neurological deficits.
- Multiple Sclerosis: An autoimmune disease that can affect the brain and spinal cord, leading to a wide range of symptoms, including dizziness and vertigo.
- Cardiac Arrhythmias: Abnormal heart rhythms can lead to reduced blood flow to the brain, causing dizziness.
- Hypothyroidism: Severe hypothyroidism can cause dizziness among other systemic symptoms.
Rare Diagnoses
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which can cause vertigo, hearing loss, and tinnitus.
- Mal de Debarquement Syndrome: A rare condition that occurs after a period of exposure to motion (like a boat ride), leading to persistent dizziness and imbalance.
- Autoimmune Inner Ear Disease: A rare condition where the immune system attacks the inner ear, leading to hearing loss and vertigo.
- 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 hearing symptoms.