Vertigo

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DDx

By episode duration

  • Auditory symptoms present
  1. Seconds: perilymphatic fistula
  2. Hours: endolymphatic hydrops (Ménière's disease, syphilis)
  3. Days: labyrinthitis, labyrinthine concussion (head trauma)
  4. Months: acoustic neuroma, ototoxicity
  • Auditory symptoms absent

  1. Seconds: positioning vertigo (cupulolithiasis), vertebrobasilar insufficiency, cervical vertigo (head-extension vertigo), diplopia
  2. Hours: recurrent vestibulopathy (Ménière's disease without auditory symptoms), vestibular migraine
  3. Days: vestibular neuronitis, head trauma
  4. Months: vertebrobasilar insufficiency, arteriovenous malformation, brainstem or cerebellar tumor, cerebellar degeneration, multiple sclerosis, vertebrobasilar migraine
Drugs
  • Anticonvulsants (eg, phenytoin), antibiotics (eg, aminoglycosides, doxycycline, metronidazole), hypnotics (eg, diazepam), analgesics (eg, aspirin), alcohol

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DDx

By episode duration

  • Auditory symptoms present
  1. Seconds: perilymphatic fistula
  2. Hours: endolymphatic hydrops (Ménière's disease, syphilis)
  3. Days: labyrinthitis, labyrinthine concussion (head trauma)
  4. Months: acoustic neuroma, ototoxicity
  • Auditory symptoms absent

  1. Seconds: positioning vertigo (cupulolithiasis), vertebrobasilar insufficiency, cervical vertigo (head-extension vertigo), diplopia
  2. Hours: recurrent vestibulopathy (Ménière's disease without auditory symptoms), vestibular migraine
  3. Days: vestibular neuronitis, head trauma
  4. Months: vertebrobasilar insufficiency, arteriovenous malformation, brainstem or cerebellar tumor, cerebellar degeneration, multiple sclerosis, vertebrobasilar migraine
Drugs
  • Anticonvulsants (eg, phenytoin), antibiotics (eg, aminoglycosides, doxycycline, metronidazole), hypnotics (eg, diazepam), analgesics (eg, aspirin), alcohol

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