Provoking factor	Suggested diagnosis
Changes in head position	Acute labyrinthitis; benign positional paroxysmal vertigo; cerebellopontine angle tumor; multiple sclerosis; perilymphatic fistula
Spontaneous episodes (i.e., no consistent provoking factors)	Acute vestibular neuronitis; cerebrovascular disease (stroke or transient ischemic attack); Ménière’s disease; migraine; multiple sclerosis
Recent upper respiratory viral illness	Acute vestibular neuronitis
Stress	Psychiatric or psychological causes; migraine
Immunosuppression (e.g., immunosuppressive medications, advanced age, stress)	Herpes zoster oticus
Changes in ear pressure, head trauma, excessive straining, loud noises	Perilymphatic fistula