Persistent Postural-Perceptual Dizziness (PPPD)

• More than three months of rocking, swaying unsteadiness and dizziness

• Symptoms occur almost daily

• Aggravated by movement, standing / sitting or complex visual environments

• Relief with lying down

• Frequently starts after an acute attack of:

• Vestibular disorder such as BPPV or Ménière’s

• Vestibular migraine

• Panic attack with dizziness

• Concussion or whiplash

• Dysautonomia

Vestibular Rehabilitation for PPPD

The vestibular system is the inner ears. Responsible for balance and stability.

Training the vestibular system can reduce dizziness symptoms as well as associated anxiety & depression. Not only does it help with balance, but also moving about.

Vestibular Rehabilitation should be continued for 3 - 6 months.

Counselling for PPPD

Counselling is helpful for reducing the likelihood of developing ongoing issues when a balance disorder first starts.

If you’ve had PPPD for a while, it’s helpful for any anxiety and depression associated with it but not as much the dizziness.

It’s not known exactly what’s happening - yet. It’s believed to involve a number of functional factors:

• Psychological components - with anxiety or depression affecting up to 75%

• Altered sensory perception

• Postural control

• Visual processing

• Vestibular processing

• Pain perception

Functional disorders, such as PPPD, means that the structure of the brain, vestibular system and other balance areas are all intact. They just are a bit wonky in the way they work.

This is like a software glitch on a computer. The computer hardware (aka the keyboard, screen and processing unit) are all working. It’s just the software that needs an update or reboot.

Vestibular rehabilitation aims to update and reboot the vestibular system.