Differential Diagnosis for Dizziness when Lying and Looking Up and Back Rolling Side to Side
- 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 or rolling from side to side. The symptoms described match closely with the typical presentation of BPPV.
- Other Likely diagnoses:
- Vestibular Migraine: Although not as directly linked to positional changes, vestibular migraines can cause vertigo and dizziness that may be exacerbated by certain movements or positions.
- Labyrinthitis: An inner ear disorder that can cause dizziness and vertigo, potentially worsened by movement or positional changes.
- 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. Given the potential severity, it's crucial to consider and rule out this diagnosis.
- Vertebral Artery Dissection: This condition can cause vertigo and is a medical emergency. It might not be the first consideration but should be evaluated, especially if other risk factors are present.
- Rare diagnoses:
- Meniere's Disease: While it primarily causes vertigo, hearing loss, and tinnitus, Meniere's could potentially be considered if the dizziness is part of a broader set of symptoms including auditory issues.
- Perilymphatic Fistula: A rare condition that can cause vertigo and dizziness, often related to trauma, surgery, or barotrauma. The symptoms can be exacerbated by positional changes.