Persistent Postural-perceptual Dizziness: A Review

Abstract

Introduction: Persistent postural-perceptual dizziness (PPPD) is characterized by chronic subjective dizziness, phobic postural vertigo, and related disorders. For at least 3 months, it exhibits varying symptoms of vertigo, unsteadiness, or dizziness. Methods: Research articles regarding PPPD were searched by viewing the Scopus, PubMed, Medline, and Google Scholar databases online. A search strategy using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used. Results: It presents a typical chronic vestibular system and brain malfunction that result in persistent dizziness, nonspinning vertigo, and/or unsteadiness. Persistent nonvertiginous dizziness and hypersensitivity to motion and visual stimuli are the main signs and symptoms of PPPD. These symptoms appeared either when there were no active neuro-otologic illnesses or when an episodic vestibular condition was present but could not completely account for the symptoms. Psychological mechanisms that resemble cognitive models of health anxiety and panic disorder are involved in the PPPDs development and maintenance. Conclusion: Since PPPDs diagnostic criteria only involve symptoms, the patient's clinical history is crucial in making the diagnosis. Once diagnosed, effective communication and personalized treatment plans, such as serotonergic medicines, cognitive behavioral therapy, and specialized physical therapy (vestibular rehabilitation), help manage PPPD. Since PPPD is a relatively recent clinical diagnosis, many medical practitioners who treat patients who feel dizzy are unfamiliar with it.