Persistent Postural Perceptual-Dizziness – now and in the future

Persistent Postural-Perceptual Dizziness (PPPD) is a new form of dizziness that has been formulated with specific diagnostic criteria for only the last 1.5 decades. Yet the disorder, by other names, has been around since the 1870’s. The published diagnostic criteria will be explained in detail punctuated with an index case example. The treatment for this disorder is a combination of anti-anxiety / depression medication, a special form of vestibular and balance therapy and in some cases use of Cognitive Behavioral Therapy. This condition typically develops from a neurotologic condition that caused dizziness but can come from any medical situation that produces unsteadiness or dizziness. The specific diagnostic criteria make this user friendly for the clinician as well as for the patient with the correct explanation. The prevalence of PPPD is estimated to by 25% of all dizzy patients reporting to tertiary care facilities for dizziness in the US. While there is currently no bio-marker for PPPD research shows a pattern on Sensory Organization Testing (SOT) of Posturography that helps expand the profile of patients felt to have PPPD. The pattern on SOT together with other recent research work further adding to the profile of the PPPD will be discussed.

Learning Objectives:

  1. Should be able to ably the diagnostic criteria for PPPD for identification of a patient possible for the disorder;
  2. Should be able to distinguish PPPD from Vestibular Migraine that is a frequent co-morbidity; and
  3. Should be able to make recommendations for the general type of Vestibular and Balance rehabilitation therapy needed as a part of the treatment program.