Persistent postural perceptual dizziness (PPPD) earlier known as phobic postural vertigo (PPV) by German neurologists, is a syndrome that affects the functioning of the brain and the vestibular system. It is caused due to disorders in the nervous system and shows the key symptoms like persistent dizziness, non-spinning vertigo and may make the person feel unsteady. PPPD dizziness lasts for a longer duration and is caused due to long-standing neuro-otological, medical or psychological events. These events are responsible for triggering vestibular systems and causing other neurological disorders. PPPD dizziness is often triggered by crowded surroundings, for eg in traffic or while sitting in crowded restaurants. If a person with PPPD dizziness is suffering from a vestibular disorder, medical illness or psychological disorder, the condition gets worse with time and symptoms are triggered even more.
PPPD symptoms may come and go without any apparent reason and settles it within a few seconds. As soon as a patient experiences any distraction, symptoms of PPPD are likely to alleviate on self.
A patient of PPPD dizziness may have significant changes in behavioral patterns including obsessive-compulsive personality, mild depression & a rise in anxiety levels. After a lot of research and studies, it has been noted that Persistent Postural Perceptual Dizziness (PPPD) is a chronic neurological condition instead of a psychiatric disorder. By now you must be clear of the fact, Persistent Postural Perceptual Dizziness is caused when you are exposed to crowds.
Patients who have a history of vertigo may likely suffer from PPPD. If any PPPD symptoms are found, it is recommended to seek medical help and consult an expert doctor for PPPD diagnosis. He will carry various tests to examine the condition of the patient and would suggest the right PPPD treatment to cure an ailment. PPPD vertigo can easily be managed with effective and customized PPPD treatment designed as per patient’s need. Patients who are diagnosed with Persistent Postural Perceptual Dizziness generally develop secondary symptoms like anxiety, avoidance behavior & severe disability.
Physical therapy (vestibular rehabilitation), serotonergic medications and cognitive-behavioral therapy are some of the common PPPD treatments suggested by doctors to patients suffering from Persistent Postural Perceptual Dizziness.
How symptoms of PPPD are triggered?
A person suffering from PPPD dizziness may experience a continuous sensation of motion. It makes the person feel dizzy or off-balance, without any spinning sensations. A person may experience the sensation of motion for at least three months or it may last even longer if the case is severe. Living with PPPD dizziness is quite a difficult task as its symptoms strike the patient regularly. Consult an expert neurologist for PPPD diagnosis. It will help you in understanding the underlying cause of Persistent Postural Perceptual Dizziness. After the diagnosis of the condition, your doctor may recommend the best PPPD treatment to cure the ailment. He would even suggest you with certain instructions that will help you in preventing PPPD symptoms from triggering further.
Here is a list of following conditions that should be avoided as they trigger PPPD symptoms and make it worse:
- Upright sitting postures or upright standing posture trigger PPPD dizziness symptoms.
- Exposure to overcrowded places or motion stimuli for eg. Crowds, traffic, etc. triggers PPPD symptoms.
- Acute vertigo spells can even trigger PPPD dizziness.
- Medical issues like dysrhythmias are likely to trigger PPPD dizziness symptoms
- Certain medications that are used in treating vertigo spells, unsteadiness or dizziness have certain side effects that can even trigger PPPD.
- High anxiety levels or mild depression can be one such possible cause of triggering PPPD.
It is recommended to avoid certain situations to prevent PPPD symptoms from triggering further. If you are still experiencing any of the symptoms, consult an expert doctor to get the best PPPD treatment.
What are some of the best Persistent Postural Perceptual Dizziness treatment?
Firstly, your doctor may seek your complete medical history before asking you to undergo a PPPD diagnosis. After you are diagnosed with Persistent Postural Perceptual Dizziness, your doctor will ask you some questions regarding the PPPD symptoms you are experiencing. It will help in examining the severity of the condition so that he can suggest the best PPPD treatment accordingly.
Here are some common PPPD treatments suggested by doctors:
- Prescribed drugs
As you are diagnosed with PPPD, your doctor may prescribe you with a dose of certain medications to treat the same. If you are at the initial stage of Persistent Postural Perceptual Dizziness, it will be treated well with a few weeks of medication. But, the prescribed drugs may show some adverse effects such as nausea, sleep disturbance, etc. in patients of PPPD. With certain medications, anxiety levels and depression are resolved in several cases. It is advised to undergo a PPPD treatment from an expert neurologist for at least a year as it helps in minimizing the recurrence of Persistent Postural Perceptual Dizziness in the near future. Some people rely on Benzodiazepines and other vestibular suppressants to treat PPPD dizziness, but they are not counted to be effective in treating PPPD as it gives very slow results.
- Counseling or Psychotherapy
A person diagnosed with Persistent Postural Perceptual Dizziness can be treated well with counseling or psychotherapy. It works well when it is used to treat the initial stage of PPPD. If a patient is experiencing PPPD dizziness for a very long duration, it is not likely to show effective results as the severity of the condition has been increased by now.
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Vestibular balance rehabilitation therapy
Vestibular balance rehabilitation therapy is suggested by doctors when patients don’t respond well with any prescribed medications and Psychotherapy doesn’t seem to work on them. Vestibular balance rehabilitation therapy helps in reducing the motion stimuli in a patient suffering from Persistent Postural Perceptual Dizziness. Doctors suggest Vestibular balance rehabilitation therapy for dealing with balance issues as it is likely to show effective results within a short time duration.
Vestibular rehabilitation therapy consists of a customized set of physical exercises as per the patient’s needs. It consists of movements of eyes, head & body to optimize vestibular compensation. It works well in reducing the bouts of dizziness and deals with balance issues. It is recommended to practice the set of VRT exercises daily for up to 6-12 weeks under expert guidance. Regular practice of Vestibular balance rehabilitation therapy reduces anxiety and depression levels in patients suffering from PPPD and helps in treating the same. Doctors generally advise continuing the therapy for 3-6 months to receive optimal results.