Persistent postural-perceptual dizziness (PPPD) is a newly defined diagnostic syndrome that unifies key features of chronic subjective dizziness, phobic postural vertigo and related disorders. It describes a common chronic dysfunction of the vestibular system and brain that produces persistent dizziness, non-spinning vertigo and/or unsteadiness. The disorder constitutes a long-term maladaptation to a neuro-otological, medical or psychological event that triggered vestibular symptoms, and is usefully considered within the spectrum of other functional neurological disorders. While diagnostic tests and conventional imaging usually remain negative, patients with PPPD present in a characteristic way that maps on to positive diagnostic criteria. Patients often develop secondary functional gait disorder, anxiety, avoidance behaviour and severe disability. Once recognised, PPPD can be managed with effective communication and tailored treatment strategies, including specialised physical therapy (vestibular rehabilitation), serotonergic medications and cognitive-behavioural therapy.
- persistent postural-perceptual dizziness
- chronic subjective dizziness
- phobic postural vertigo
- visual vertigo
- functional dizziness
Statistics from Altmetric.com
Contributors SP wrote the first draft of the article, and all authors were involved in rewrites.
Funding This work was supported in part by a scholarship for SP from the FoRUM Forschungsreferat (research office) of the Medical Faculty of the Ruhr-University Bochum, Germany. JeS is supported by research funding from the US National Institute on Deafness and Other Communication Disorders and Mayo Clinic. JoS is supported by an NHS Scotland NRS Career Fellowship.
Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed. This paper was reviewed by Adolfo Bronstein, London, UK.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.