Differential Diagnosis for a Two-Day History of Vertigo Following a URI
- Single most likely diagnosis
- Vestibular Neuritis (also known as vestibular neuronitis): This condition is characterized by inflammation of the vestibular nerve, often following a viral infection like a URI. The sudden onset of vertigo, which can be severe and debilitating, is a hallmark symptom. The close temporal relationship between the URI and the onset of vertigo supports this diagnosis.
- Other Likely diagnoses
- Benign Paroxysmal Positional Vertigo (BPPV): Although BPPV typically presents with brief episodes of vertigo triggered by specific head movements, it can sometimes occur after a viral infection. The history of URI could potentially be coincidental, but it's worth considering, especially if the vertigo is positional.
- Labyrinthitis: This is an inner ear disorder characterized by inflammation of the labyrinth, which can be caused by a viral infection. Symptoms include vertigo, hearing loss, and sometimes tinnitus. The recent URI makes this a plausible diagnosis, especially if there are accompanying auditory symptoms.
- Do Not Miss diagnoses
- Posterior Circulation Stroke (including cerebellar stroke or lateral medullary syndrome): Although less common, a stroke can present with vertigo as a primary symptom. Given the potential for severe and permanent neurological damage, it's crucial to consider and rule out a stroke, even in the context of a recent URI.
- Multiple Sclerosis (MS): MS can present with vertigo among other neurological symptoms. While less likely, the diagnosis of MS is critical due to its long-term implications and the need for specific treatment.
- 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. It's a rare condition but should be considered if symptoms persist or worsen over time.
- Meniere's Disease: Characterized by a group of symptoms, including vertigo, tinnitus, hearing loss, and ear fullness, that are associated with an inner ear disorder. While it could be a consideration, the acute onset following a URI makes it less likely in this context.