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Semin Neurol 2020; 40(01): 130-137
DOI: 10.1055/s-0039-3402736
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Persistent Postural-Perceptual Dizziness

Jeffrey P. Staab
1   Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
2   Department of Otorhinolaryngology – Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
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Publication History

Publication Date:
14 January 2020 (online)

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Abstract

Persistent postural-perceptual dizziness (PPPD) was defined for the International Classification of Vestibular Disorders in 2017. It is a chronic vestibular disorder that manifests with waxing and waning symptoms of dizziness, unsteadiness, or nonspinning vertigo that last for 3 months or more and are exacerbated by upright posture, active or passive motion of self, and exposure to environments with complex or moving visual stimuli. Triggers of PPPD include a wide variety of conditions that may cause vestibular symptoms or disrupt balance functioning, including neuro-otologic and other medical conditions and psychological distress. The diagnosis is made by identifying key symptoms in patients' histories and conducting physical examinations and diagnostic testing of sufficient detail to establish PPPD as opposed to other illnesses. Ongoing research is providing insights into the pathophysiological mechanisms underlying PPPD and support for multimodality treatment plans incorporating specially adapted vestibular rehabilitation, serotonergic medications, and cognitive-behavior therapy.

Keywords

chronic dizziness - visual dependence - postural control - neurologic disorder
 

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