Why am I still dizzy? PPPD

Posted on June 23, 2023 by - Physiotherapy

A significant proportion of the community will struggle with episodes of dizziness at some point in their lifetime. For most, these episodes can be investigated and managed effectively so that symptoms resolve back to normal.

However, sometimes dizziness can linger and become a daily burden impacting on quality of life and make normal activities of life challenging and stressful.

Persistent Postural-Perceptual Dizziness, sometimes called PPPD – is one possible specific cause of prolonged dizziness, particularly in middle aged people1. Symptoms of PPPD are a mixture of rocking, swaying, dizziness, and unsteadiness, aggravated by movement, large changes in position of the head, and dizziness in fast moving or crowded environments such as public transport or shopping centers. These symptoms can occur at least every second day for a period of 3 months or longer.1

The exact cause of PPPD is still unknown and is continuing to be investigated through research. It is believed to be caused by a disruption between visual and postural control mechanisms. Commonly, the condition can result from an initial vestibular condition such as:1

  • Vestibular neuritis
  • BPPV
  • Meniere Disease
  • Other vascular or traumatic events that have caused dizziness

Sometimes PPPD can occur after an incomplete recovery from the initial condition or chronic and recurring episodes of dizziness.

Diagnosis of PPPD is determined by excluding any other potential causes of dizziness. This may include undergoing physical examination, medical imaging for the neck and head, and blood testing. These investigations should be clear of any other relevant issues for a PPPD diagnosis to be confirmed.

So, what can be done to help if you’re experiencing PPPD?

A combination of treatments will assist to address the common concerns and symptoms that come with persistent dizziness. These treatments include:1

  • Seeing a vestibular physiotherapist: Assessment of your symptoms and provision of vestibular training exercises can help to improve the level of function and coordination in your vestibular systems.
  • Seeing a GP: To discuss the appropriate medications to aide in minimizing dizziness symptoms and managing the anxiety and stress than can often accompany prolonged periods of dizziness
  • You may benefit also from receiving counselling: To help acknowledge and manage some of the stresses and anxieties that may accompany prolonged periods of dizziness.

If you have found the information above to be helpful and you believe you may be experiencing persistent dizziness, please contact us to arrange a consultation with one of our Vestibular Physiotherapists who have a special interest and specific training in managing vestibular disorders.

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References

  1. Knight B, Bermudez F, Shermetaro C. Persistent Postural-Perceptual Dizziness. 2023 Jan 23. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 35201726.

Vestibular Management