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
