Persistent postural perceptual dizziness

Persistent postural-perceptual dizziness refers to a recently (c. 2017) defined diagnostic syndrome. It unifies key features of chronic subjective dizziness, phobic postural vertigo and related disorders. It produces persistent dizziness, non-spinning vertigo and/or unsteadiness.

Clinical presentation

It can manifest with one or more symptoms of dizziness, unsteadiness, or non-spinning vertigo that are present on most days for ≥3 months and is exacerbated by upright posture, active or passive movement, and exposure to moving or complex visual stimuli.

Pathology

The pathophysiological processes at the time of writing (2019) are not fully known. Some suggest that it may arise from functional changes in postural control mechanisms, multi-sensory information processing, or cortical integration of spatial orientation and threat assessment.

Radiographic features

Since it is considered a functional condition, it is a diagnosis of exclusion and imaging is only useful to rule out other structural conditions that could result in similar symptoms.