Persistent postural-perceptual dizziness (PPPD): A common, characteristic and treatable cause of chronic dizziness

Stoyan Popkirov, Jeffrey P. Staab, Jon Stone

Research output: Contribution to journalReview article

49 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)5-13
Number of pages9
JournalPractical neurology
Volume18
Issue number1
DOIs
StatePublished - 2018

ASJC Scopus subject areas

  • Clinical Neurology

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