PERSISTENT POSTURAL PERCEPTUAL DIZZINESS (PPPD)

Persistent postural-perceptual dizziness (PPPD) is a chronic functional disorder of the nervous system, characterised by non-spinning vertigo, perceived unsteadiness and the dizziness is not caused by injury to the inner ears. The symptoms are often exacerbated when patients assume upright postures and are in situations with complex or moving stimuli, can be alleviated transiently during moments of distraction but they can also flare up without any apparent reason.

In many cases, PPPD is triggered by an initial incident of true vertigo, such as BPPV, however once the initial vertigo is resolved you are left with persistent dizziness. With PPPD all medical testing and imaging will come back as normal/clear as there is no structural or lesional disease.
 
Symptoms include:

  • Persistent sensations of rocking or swaying unsteadiness and/or dizziness without vertigo for more than 3 months
  • Symptoms are present on more days than not (greater than 15 days in the month); most patients have daily symptoms
  • Symptoms are typically worse with:
    • Upright posture
    • Head or body motion
    • Exposure to complex or motion rich environments
  • Typically starts shortly after an event that causes acute vertigo such as BPPV, panic attacks with dizziness, stroke etc. 

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