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.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less common, vertigo can be a symptom of a stroke or TIA, especially if accompanied by other neurological deficits. Missing this diagnosis can be catastrophic.
- Posterior Circulation Stroke: Specifically, vertebrobasilar insufficiency can cause vertigo among other symptoms like double vision, weakness, and difficulty speaking.
- Multiple Sclerosis: In some cases, vertigo can be an initial symptom of multiple sclerosis, an autoimmune disease affecting the central nervous system.
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.
- Ototoxicity: Certain medications or chemicals can damage the inner ear, leading to vertigo, hearing loss, and balance problems.
- 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.