Differential Diagnosis for Back of Head Dizziness
Single Most Likely Diagnosis
- Benign Paroxysmal Positional Vertigo (BPPV): This condition is characterized by brief, intense episodes of vertigo triggered by specific head movements, which could be perceived as dizziness in the back of the head. Its high prevalence and the nature of the symptoms make it a likely candidate.
Other Likely Diagnoses
- Cervicogenic Dizziness: This condition arises from cervical spine disorders and can cause dizziness, including sensations in the back of the head, due to the close relationship between the cervical spine and the vestibular system.
- Migraine-Associated Vertigo: Migraines can cause vertigo and dizziness, which some patients might describe as being located in the back of the head, especially if they experience neck pain or stiffness as part of their migraine syndrome.
- Vestibular Migraine: Similar to migraine-associated vertigo, vestibular migraines can cause episodes of vertigo without headache, and the sensation might be perceived in the back of the head.
Do Not Miss Diagnoses
- Posterior Circulation Stroke: Although less common, a stroke in the posterior circulation (including the vertebrobasilar system) can present with vertigo, dizziness, or a sensation of instability that might be localized to the back of the head. Missing this diagnosis could be catastrophic.
- Multiple Sclerosis: In rare cases, multiple sclerosis can present with vertigo or dizziness due to lesions in the central nervous system affecting balance pathways.
- Acoustic Neuroma: A benign tumor on the vestibulocochlear nerve can cause vertigo, dizziness, and balance problems, which might be perceived as being in the back of the head, along with hearing loss.
Rare Diagnoses
- Chiari Malformation: A structural defect in the cerebellum that controls balance can cause dizziness and vertigo, potentially perceived in the back of the head, especially with certain head movements.
- Superior Canal Dehiscence: A rare condition where there is an abnormal opening in the bone overlying the superior canal of the inner ear, leading to vertigo and dizziness in response to sound or pressure changes.
- Labyrinthitis: An inner ear disorder characterized by inflammation of the labyrinth, which can cause severe vertigo, dizziness, and might be perceived as affecting the back of the head.