RT Journal Article SR Electronic T1 Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness JF Practical Neurology JO Pract Neurol FD BMJ Publishing Group Ltd SP practneurol-2017-001809 DO 10.1136/practneurol-2017-001809 A1 Stoyan Popkirov A1 Jeffrey P Staab A1 Jon Stone YR 2017 UL http://pn.bmj.com/content/early/2017/12/05/practneurol-2017-001809.abstract AB 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.