Benign paroxysmal positional vertigo differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Differentiating [Disease name] from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].

OR

As [disease name] +in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].

Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]

On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging
Acute onset Recurrency Nystagmus Hearing problems
Peripheral
BPPV + + +/−
Vestibular neuritis + +/− + /−

(unilateral)

  • + Head thrust test
HSV oticus + +/− +/− + VZV antibody titres
Meniere disease +/− + +/− + (Progressive)
Labyrinthine concussion + +
Perilymphatic fistula +/− + +
  • CT scan may show fluid around the round window recess
Semicircular canal

dehiscence syndrome

+/− + +

(air-bone gaps on audiometry)

Vestibular paroxysmia + + +/−

(Induced by hyperventilation)

Cogan syndrome + +/− + Increased ESR and cryoglobulins
  • In CT scan we may see calcification or soft tissue attenuation obliterating the intralabyrinthine fluid spaces
Vestibular schwannoma + +/− +
Otitis media + +/− Increased acute phase reactants
Aminoglycoside toxicity + +
Recurrent vestibulopathy +
  • It may happen infrequently, every one to two years
  • It may be associated with nausea and vomiting
  • It may overlap with vestibular migraine
Central
Vestibular migrain + +/− +/−
  • History of migraine headaches
  • They may have white-matter hyperintensities (WMHs) on MRI
  • ICHD-3 criteria
  • It may be associated with anxiety and depression
Epileptic vertigo +
Multiple sclerosis
Brain tumors
Crebellar infarction/hemorrhage +
Brain stem ischemia +
Chiari malformation
Parkinson

References

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