Dizziness DDx

Dizziness – Differential Diagnosis

Eppley’s Maneuver

Common causes

• Viral illness
• Vertigo
  • Labyrinthitis
  • Vestibular neuritis
  • BPPV
  • Meniere’s disease
• Psychogenic (Anxiety)
• Elderly patients
  • Cervical spondylosis
  • Multifactorial
• Vasovagal syncope
• Orthostatic hypotension
• Vestibular migraine
• Anaemia
• Hypothyroidism
• Idiopathic

Must Not Miss

• Hypoglycaemia
• Vascular
  • CVA / TIA
  • Arrhythmia
  • Myocardial Infarction
  • Pulmonary embolism
  • Valvular heart disease
• ‘Tumour’
  • Cerebral tumour/ SOL
  • Acoustic neuroma
  • Cholesteatoma
• Seizure / Pseudoseizure
• Multiple sclerosis

Easily missed

• Medications
• Drugs& Alcohol
• Vertebrobasilar insufficiency
• Autonomic neuropathy
• Addison’s disease

Red flags

• Progressive symptoms
• Confusion/behavioural changes
• Associated symptoms
  • Collapse
  • Chest pain
  • Dyspnoea
  • Headache
  • Neurological symptoms
  • Hearing loss

Investigations to consider

• FBC, CRP/ESR
• U+Es, LFTs, Bone profile, Serum glucose
• Urinalysis
• CXR
• CT scan/MRI
• ECG/24h ECG
• Echocardiogram
• Audiometry
• Carotid Doppler
• EEG