PPPD stands for persistent postural-perceptual dizziness. It is a long-lasting kind of dizziness, and it is common. It is a real condition with a recognised pattern. It is not imagined.
What it feels like
- Dizziness or unsteadiness on most days, for three months or more. It is usually a swaying, rocking or "not solid" feeling rather than a spin.
- It is often worse when standing or walking, when moving, and in busy visual places: supermarkets, crowds, traffic, scrolling screens or patterned floors.
- It may ease when lying down.
- It can come and go in strength through the day.
How it often starts
PPPD often begins after something that upset the balance system, such as a bout of vestibular neuritis, BPPV, a vestibular migraine attack, a concussion, or a time of great stress or anxiety. The first problem settles, but the brain stays in a high-alert balance mode and keeps relying heavily on vision.
How it is diagnosed
There is no single test. A doctor, usually an ENT specialist or neurologist, makes the diagnosis from the pattern of symptoms and checks for other causes.
How it is managed
Treatment is often a combination, chosen with your clinician:
- Vestibular rehabilitation, especially gradual habituation to the movements and places that bother you.
- Talking therapies such as cognitive behavioural therapy, which help the nervous system settle.
- Sometimes medicines.
Improvement is usually gradual. Many people get a lot better.
In VertigoMe
- Choose PPPD (persistent dizziness) as your subtype. Because PPPD often follows vestibular migraine, the Headache page stays in your spin log.
- Daily logging and the Daily Check-In suit a condition that is there most days.
- The Exercises row (Premium) includes Habituation exercises and Balance retraining.
- The VSS-SF questionnaire helps you track how much your symptoms bother you over time.
This is general information only. It cannot tell you what is causing your symptoms. Please speak to your GP, ENT, neurologist or audiologist about your own situation.
