Differential Diagnosis for Dizziness with Nausea
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, intense episodes of vertigo triggered by specific head movements, often accompanied by nausea. It's a common cause of dizziness and typically has a benign course.
Other Likely Diagnoses
- Vestibular Migraine: A condition that involves vertigo, often with nausea and vomiting, and can be accompanied by migraine headaches. It's a common cause of episodic vertigo.
- Labyrinthitis: An inner ear disorder characterized by inflammation of the labyrinth, leading to vertigo, nausea, and sometimes hearing loss.
- Motion Sickness: A common condition triggered by conflicting signals between the sensory systems, leading to nausea, vomiting, and dizziness during travel.
- Inner Ear Infection: Infections such as otitis media or otitis interna can cause dizziness and nausea due to the involvement of the vestibular system.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less common, vertigo can be a presenting symptom of a stroke or TIA, especially if accompanied by other neurological deficits. Early recognition is crucial for timely intervention.
- Meniere's Disease: A disorder of the inner ear that affects balance and hearing, leading to episodes of vertigo, nausea, and hearing loss. While not immediately life-threatening, it significantly impacts quality of life.
- Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which can cause vertigo, nausea, and hearing loss. Early diagnosis is important for treatment planning.
Rare Diagnoses
- Multiple Sclerosis: An autoimmune disease that can affect the brain and spinal cord, leading to a wide range of symptoms, including vertigo and nausea, though these are less common initial presentations.
- Mal de Debarquement Syndrome: A rare condition where vertigo and nausea persist after the cessation of motion, typically after a boat ride.
- Perilymphatic Fistula: An abnormal connection between the inner and middle ear, leading to vertigo, nausea, and hearing loss, often after head trauma or barotrauma.