Persistent Postural-Perceptual Dizziness – The Basics

Persistent Postural-Perceptual Dizziness – The Basics

If you are between the ages of 30 and 50 and you suffer from chronic dizziness or other symptoms involving the inner ear, you may be suffering from Persistent postural-perceptual dizziness (PPPD). PPPD negatively affects normal daily functioning of many patients, but there’s no need to suffer. There are treatments that can help you get your life back.

Discovery of PPPD

In the 1980’s, Brandt and Dieterich described a condition they called phobic postural vertigo (PPV). This condition was an early understanding of the condition now known as PPPD. In the early 2000’s, Staab et al studied the condition, updating the medical community’s understanding.

In 2014, the name of the condition was changed to Persistent Postural-Perceptual Dizziness (PPPD) and diagnostic criteria were updated and standardized. The World Health Organization has now added PPPD to its list of additions to the International Classification of Diseases (ICD-11) in 2017.

PPPD Symptoms

The primary symptom of PPPD is a feeling of dizziness or unsteadiness, generally without feelings of vertigo. PPPD is a chronic condition involving dizziness that occur at least several times a week for at least three months, while some patients will experience symptoms on a daily basis.

There are a few situations in which the symptoms of PPPD become worse, particularly when changing positions, such as sitting up after lying down or standing after sitting, or any head motion, and in busy environments involving a lot of motion.

Factors that can aggravate PPPD symptoms

An attack of PPPD can occur spontaneously or in response to certain situations. These factors can also aggravate symptoms that are already present. These factors include movement of the head, either active or passive, any sudden or rapid movement, standing or sitting upright, especially when moving into the upright position, and exposure to visual movement .

Diagnosing Persistent Postural-Perceptual Dizziness

Diagnosing PPPD can be complicated because it does not show up on diagnostic tests such as neuroimaging, lab tests, or a physical exam, though these tools may be used to rule out conditions that may cause similar symptoms. Criteria for diagnosing PPPD involve unsteadiness or dizziness that may come and go, but are present most days for at least three months .

Causes of PPPD

It is not always easy, or even possible to determine the cause of PPPD, but it can be triggered by vestibular disorders such as vestibular neuritis, vestibular migrain, or benign paroxysmal positional vertigo, or by other medical or psychiatric conditions that can affect balance or cause vestibular symptoms.

Treating Persistent Postural-Perceptual Dizziness

There have been few large scale studies on Persistent Postural-Perceptual Dizziness, but small scale studies have shown that medication and Vestibular Balance Rehabilitation Therapy (VBRT) may both be effective treatments for PPPD.

Medication – Serotonin norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs) may help alleviate dizziness.

VBRTVestibular balance symptom of pppd

rehabilitation therapy involves exercises designed to improve habituation, balance, and gait, and to stabilize visual gaze. These exercises may also ease symptoms of depression and anxiety in sufferers and require 3-6 months of regular treatment.

If you think your dizziness may be the result of PPPD, call Brain Hub on 1300 770 197 to find out if dizziness treatment can help you.