Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the classification of vestibular disorders of the barany society

Jeffrey P. Staab, Annegret Eckhardt-Henn, Arata Horii, Rolf Jacob, Michael Strupp, Thomas Brandt, Adolfo Bronstein

Research output: Contribution to journalArticle

119 Scopus citations

Abstract

This paper presents diagnostic criteria for persistent postural-perceptual dizziness (PPPD) to be included in the International Classification of Vestibular Disorders (ICVD). The term PPPD is new, but the disorder is not. Its diagnostic criteria were derived by expert consensus from an exhaustive review of 30 years of research on phobic postural vertigo, space-motion discomfort, visual vertigo, and chronic subjective dizziness. PPPD manifests with one or more symptoms of dizziness, unsteadiness, or non-spinning vertigo that are present on most days for three months or more and are exacerbated by upright posture, active or passive movement, and exposure to moving or complex visual stimuli. PPPD may be precipitated by conditions that disrupt balance or cause vertigo, unsteadiness, or dizziness, including peripheral or central vestibular disorders, other medical illnesses, or psychological distress. PPPD may be present alone or co-exist with other conditions. Possible subtypes await future identification and validation. The pathophysiologic processes underlying PPPD are not fully known. Emerging research suggests that it may arise from functional changes in postural control mechanisms, multi-sensory information processing, or cortical integration of spatial orientation and threat assessment. Thus, PPPD is classified as a chronic functional vestibular disorder. It is not a structural or psychiatric condition.

Original languageEnglish (US)
Pages (from-to)191-208
Number of pages18
JournalJournal of Vestibular Research: Equilibrium and Orientation
Volume27
Issue number4
DOIs
StatePublished - 2017

Keywords

  • Barany Society
  • Chronic subjective dizziness
  • classification
  • phobic postural vertigo
  • space motion discomfort
  • visual vertigo

ASJC Scopus subject areas

  • Neuroscience(all)
  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

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