Summary
Differentials
Common
- Benign positional paroxysmal vertigo (BPPV)
- Meniere disease
- Vestibular neuritis
- Labyrinthitis
- Vestibular migraine
- Presyncope
- Orthostatic hypotension
- Postural orthostatic tachycardia syndrome
- Diabetes mellitus
- Alcohol
- Drugs
- Coronavirus disease 2019 (COVID-19)
Uncommon
- Cholesteatoma
- Superior semicircular canal dehiscence
- Perilymphatic fistula
- Persistent postural-perceptual dizziness (PPPD)
- Posterior fossa tumor
- Multiple sclerosis
- Posterior circulation stroke
- Vertebrobasilar insufficiency
- Arnold-Chiari malformation type 1
- Wallenberg syndrome (Lateral medullary infarction)
- Trauma
- Vertebral artery dissection
- Paraneoplastic cerebellar degeneration
- Idiopathic intracranial hypertension
- Normal pressure hydrocephalus
- Mal de debarquement syndrome
- Psychophysiological dizziness
- Psychogenic dizziness
- Systemic lupus erythematosus (SLE)
- Cogan syndrome
- Granulomatosis with polyangiitis (formerly known as Wegener granulomatosis)
- Behcet disease
- Carbon monoxide poisoning
- Postsurgery
- Secondary syphilis
Contributors
Authors
Susan A. Douglas, MBBS (Hons) UWI, FRCSEd, FRCS (ORL-HNS)
Consultant Otolaryngologist and Otologist
Rotherham NHS Foundation Trust
Rotherham
UK
Disclosures
SAD declares that she has no competing interests.
Acknowledgements
Dr Susan A. Douglas would like to thank Professor William Gibson, a previous contributor to this topic.
Disclosures
WG is an author of a reference cited in this topic.
Peer reviewers
Joel Goebel, MD, FACS
Professor and Vice Chairman
Residency Program Director
Dizziness and Balance Center Director
Otolaryngology-Head and Neck Surgery
Washington University School of Medicine
St. Louis
MO
Disclosures
JG is an author of a number of references cited in this topic.
Iain Swan, MD, FRCS
Senior Lecturer in Otolaryngology
Honorary Consultant Otolaryngologist
Glasgow Royal Infirmary
Glasgow
UK
Disclosures
IS declares that he has no competing interests.
References
Key articles
Bhattacharyya N, Gubbels SP, Schwartz SR, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017 Mar;156(suppl 3):S1-47. Abstract
Basura GJ, Adams ME, Monfared A, et al. Clinical practice guideline: Ménière's disease. Otolaryngol Head Neck Surg. 2020 Apr;162(2_suppl):S1-55.Full text Abstract
American College of Radiology. ACR appropriateness criteria: dizziness and ataxia. 2023 [internet publication].Full text
American College of Radiology. ACR Appropriateness Criteria: hearing loss and/or vertigo. 2018 [internet publication].Full text
Shen WK, Sheldon RS, Benditt DG, et al. 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2017 Aug 1;136(5):e60-122.Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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