Differential Diagnosis for Vertigo with Nausea
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is the most common cause of vertigo and is characterized by brief, episodic vertigo triggered by specific head movements. The symptoms of BPPV, including vertigo and nausea, are often precipitated by changes in the position of the head, making it a likely diagnosis for patients presenting with these symptoms.
Other Likely Diagnoses
- Vestibular Migraine: A condition that involves vertigo, often accompanied by headache, nausea, and sensitivity to light and sound. It's a common cause of vertigo in patients with a history of migraines.
- Labyrinthitis: An inner ear disorder characterized by inflammation of the labyrinth, which can cause vertigo, nausea, and hearing loss. It often follows a viral infection.
- Meniere's Disease: A disorder of the inner ear that causes episodes of vertigo, ringing in the ears (tinnitus), hearing loss, and a feeling of fullness in the ear. The vertigo episodes can be severe and are often accompanied by nausea.
Do Not Miss Diagnoses
- Stroke or Transient Ischemic Attack (TIA): Although less common, vertigo can be a symptom of a stroke or TIA, especially if accompanied by other neurological deficits such as weakness, numbness, or difficulty with speech. Missing this diagnosis could be catastrophic.
- Posterior Circulation Stroke: Specifically, strokes involving the cerebellum or brainstem can present with vertigo, nausea, and vomiting, and are medical emergencies.
- Multiple Sclerosis: In some cases, vertigo can be a presenting symptom of multiple sclerosis, an autoimmune disease affecting the brain and spinal cord.
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.
- Perilymphatic Fistula: A rare condition involving an abnormal connection (fistula) in the inner ear, leading to vertigo, hearing loss, and balance problems.
- Mal de Debarquement Syndrome: A rare condition where vertigo persists after a journey by boat, plane, or car, and can last for months after the trip.