What are the causes of vertigo (dizziness)?

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Last updated: April 16, 2025View editorial policy

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Differential Diagnosis for Dizziness

Single Most Likely Diagnosis

  • Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, episodic vertigo triggered by specific head movements. It's a common cause of dizziness, especially in older adults, due to the displacement of otolith crystals in the inner ear.

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 dizziness in patients with a history of migraines.
  • Labyrinthitis: An inner ear disorder characterized by inflammation of the labyrinth, which can cause vertigo, hearing loss, and tinnitus. It often follows a viral infection.
  • Medication Side Effects: Various medications, including antihistamines, antidepressants, and blood pressure medications, can cause dizziness as a side effect.
  • Orthostatic Hypotension: A sudden drop in blood pressure upon standing, leading to dizziness or lightheadedness. It can be due to dehydration, blood loss, or certain medications.

Do Not Miss Diagnoses

  • Stroke or Transient Ischemic Attack (TIA): Although less common, vertigo can be a symptom of a stroke or TIA, especially when 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, causing episodes of vertigo, tinnitus, hearing loss, and ear fullness. While not immediately life-threatening, it significantly impacts quality of life.
  • Cardiac Arrhythmias: Abnormal heart rhythms can lead to reduced cardiac output, resulting in dizziness or syncope. Conditions like atrial fibrillation or ventricular tachycardia require prompt medical attention.

Rare Diagnoses

  • Acoustic Neuroma: A rare, benign tumor on the nerve connecting the inner ear to the brain, which can cause vertigo, hearing loss, and tinnitus.
  • Multiple Sclerosis: An autoimmune disease that can affect the brain and spinal cord, leading to a wide range of symptoms, including vertigo, depending on the areas affected.
  • Mal de Debarquement Syndrome: A rare condition characterized by persistent vertigo and imbalance after a sea voyage or other motion experience, which can last for months or even years.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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