Differential Diagnosis for Vertigo when Looking Up
- Single most likely diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, intense episodes of vertigo triggered by specific head movements, such as looking up. The vertigo is usually accompanied by nystagmus and is due to the movement of otolith crystals in the inner ear.
- Other Likely diagnoses
- Cervicogenic Vertigo: This type of vertigo is caused by cervical spine disorders, such as cervical spondylosis or cervical disc herniation, which can affect the neck's proprioceptive receptors and lead to vertigo when looking up.
- Vestibular Migraine: Although not exclusively triggered by looking up, vestibular migraines can cause vertigo and may be exacerbated by certain head movements.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Posterior Circulation Stroke: Although less common, a stroke affecting the posterior circulation can present with vertigo, among other symptoms. It's crucial to rule out this life-threatening condition.
- Vertebral Artery Dissection: This condition can cause vertigo, especially when looking up, due to the involvement of the vertebral artery, which supplies blood to the brainstem and cerebellum.
- Rare diagnoses
- Superior Canal Dehiscence Syndrome: A rare condition where there is an abnormal opening in the bone overlying the superior canal of the inner ear, leading to vertigo triggered by sound or pressure changes, including certain head movements.
- Chiari Malformation: A structural defect in the cerebellum that can cause vertigo, among other symptoms, especially with certain head movements or positions, including looking up.