What is Persistent Postural Perceptual Dizziness?

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Published 2022-03-04

On today’s episode, Dr. Nick talks about a common form of chronic vertigo called Persistent Postural-Perceptual Dizziness (PPPD). This chronic vestibular syndrome is persistent due to changes in the brain that have occurred usually following a more acute form of vertigo like a viral infection or benign paroxysmal positional vertigo (BPPV). It is characterized by dizziness that gets worse with upright posture/walking, active or passive movements, and excess visual stimuli. Most patients have the problem with complex movements that occur around them like being in a large crowd or driving. Others have problems walking at a normal pace, and some have both problems. This can be really detrimental to people’s work and social life and prevent them from striving for their health goals. Check out the video for more in depth information on PPPD and how we fix it!

Yagi C, Morita Y, Kitazawa M, et al. Subtypes of Persistent Postural-Perceptual Dizziness. Front Neurol. 2021;12:652366.

All Comments (10)

@servicedogskidboot 14 days ago

Would love a video about vestibular paroxysmia. I've also been diagnosed with VM and PPPD, but there isn't much info about VP. Thanks!
@DiamondForevah 2 years ago

What are the best exercises to treat visual dependency? Optokinetic exercises?
@808soldier 5 months ago

Thats me Doc on Maui. Since 2018 til now. What can I do to find treatment.
@user-vv8ht6ue7c 1 year ago

Does Videonystagmography test shows pppd?
@2centjoe790 1 year ago

How do I get my neurologist to take me seriously I get sent back and forth from ENT to neurologist and I still have issues.
@carissakinder029 2 years ago

I have this as well as vestibular migraine. This is all new to me. Took me a long time to get diagnosed. I just want to be better again. 😔
@janeichimura3222 3 months ago

I have had this dizziness since I had COVID 19. When I stand I get light headed. Mostly I st ay seated.
@francafranchi 2 years ago

Hi... I believe I have this condition. My crystals went out of place few months ago and things never were the same even if they went back in place with the Epleys maneuver. I get now some kind of weird sensations when I scroll my phone, or whatch TV and something moves really fast panning or zooming in or out. I feel like fear in my stomach and that I move with the scroll. I had a second episode of the crystals just a week ago after just 3 months of the first one. Unfortunately the health system is so bad where I am that I didn't find a doctor to do the maneuver as soon as possible, and I ended doing myself at home and it actually seemed to have worked out well. But this unusual visual vertigo keeps happening very often. I'm in Lisboa, Portugal. Is there anyway I can reach out to a doctor doing what you do to help your patients there? Or maybe are there some exercises you can teach me to rewire my brain properly with this? I've been thinking it was a PTSD from the first episode because I got so scared that I got traumatized by the event, so all these months I've been thinking maybe it's a PTSD response. But maybe is what you're e describing here. What can I do? I'm only 46. I don't want to live with this random sensation for life. Thanks for reading.
@bethhagendorf 1 year ago

Hi Dr. Thanks for the video. I’ve had 3PD about 9 months. Took me 3 months to diagnose it myself. It has changed and evolved from strong swinging sensations that were very scary for me to a strong headache to now very subtle ongoing head swing or shifting sensations in my head. It can be created by thought alone now that my head knows it so well. Sadly with anxiety it can manifest. I’m 41 an athlete which I believe my training in the gym is great it very similar to what my Vestibular Physical Therapist had me do. I know the longer I have this the least likely I can hea myself from it. I’ve done my best by taking busiprone a mild anxiety medicine I do not believe in SNRI they re-wire your brain and is only a band aid. I live in Texas and just want to volunteer myself my head case 😅 for any studies you may have. Sadly the doctors I work with is me teaching them about it. My email is beth @ beth dot tv thanks!!