![]() ![]() ![]() In the 1870 s, three German physicians described syndromes of dizziness and discomfort in motion rich environments, accompanied by autonomic arousal, anxiety, and avoidance of provocative circumstances. It is not a structural or psychiatric condition. Thus, PPPD is classified as a chronic functional vestibular disorder. ![]() Emerging research suggests that it may arise from functional changes in postural control mechanisms, multi-sensory information processing, or cortical integration of spatial orientation and threat assessment. The pathophysiologic processes underlying PPPD are not fully known. Possible subtypes await future identification and validation. PPPD may be present alone or co-exist with other conditions. PPPD may be precipitated by conditions that disrupt balance or cause vertigo, unsteadiness, or dizziness, including peripheral or central vestibular disorders, other medical illnesses, or psychological distress. PPPD manifests with one or more symptoms of dizziness, unsteadiness, or non-spinning vertigo that are present on most days for three months or more and are exacerbated by upright posture, active or passive movement, and exposure to moving or complex visual stimuli. Its diagnostic criteria were derived by expert consensus from an exhaustive review of 30 years of research on phobic postural vertigo, space-motion discomfort, visual vertigo, and chronic subjective dizziness. The term PPPD is new, but the disorder is not. ![]() This paper presents diagnostic criteria for persistent postural-perceptual dizziness (PPPD) to be included in the International Classification of Vestibular Disorders (ICVD). ![]()
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