Differential Diagnosis for Vertigo with Hypertension (b/p 185/100)
- Single most likely diagnosis:
- Benign Paroxysmal Positional Vertigo (BPPV) - This condition is a common cause of vertigo and can be exacerbated by or unrelated to hypertension. The high blood pressure might be an incidental finding or could contribute to the patient's overall vascular health, potentially affecting inner ear function.
- Other Likely diagnoses:
- Labyrinthitis - An inner ear disorder that can cause vertigo, and while not directly related to hypertension, the overall vascular health of the patient could influence the condition.
- Meniere's Disease - A disorder of the inner ear that affects balance and hearing, with vertigo being a key symptom. Hypertension could be a contributing factor to the disease's progression or severity.
- Vestibular Migraine - Although typically associated with headache, some patients may experience vertigo without headache, and hypertension could be a comorbidity.
- Do Not Miss diagnoses:
- Posterior Circulation Stroke (e.g., Lateral Medullary Syndrome or Wallenberg's Syndrome) - Given the high blood pressure, a stroke must be considered, especially if other neurological deficits are present. Vertigo can be a presenting symptom of a posterior circulation stroke.
- Hypertensive Encephalopathy - While less common, severely elevated blood pressure can lead to encephalopathy, which might present with vertigo among other symptoms like headache and altered mental status.
- Rare diagnoses:
- Multiple Sclerosis - Although rare, MS can present with vertigo as part of its initial symptoms, and hypertension might be an unrelated comorbidity.
- Acoustic Neuroma - A benign tumor on the nerve connecting the inner ear to the brain, which can cause vertigo. Hypertension would likely be an incidental finding in this case.
- Superior Canal Dehiscence Syndrome - A rare condition of the inner ear that can cause vertigo and is often associated with loud noises, but not directly with hypertension.