PPPD Symptoms

Symptoms of persistent postural-perceptual dizziness range from mild to severe. They last for at least three months. You feel symptoms most days for hours at a time.

PPPD symptoms may include:

• Dizziness or non-spinning vertigo (feeling like your surroundings are moving or rocking but not spinning)
• Unsteadiness or feeling a swaying, wobbling, or veering sensation
• Cloudiness or heaviness (brain fog)

The disorder affects your ability to perform daily activities, such as walking or driving. You might feel so scared of falling that you avoid going places or doing things that worsen your symptoms. Sometimes, your symptoms may feel better or get worse. For example, you may find relief when you lie down or are distracted. On the other hand, symptoms may worsen when you:

Causes of PPPD

Researchers don’t know what causes persistent postural-perceptual dizziness. PPPD may develop slowly over time from a chronic condition. However, symptoms usually start after an alarming event that affects your balance, mental well-being, or medical health. For example, you may have a:

These events activate your fight or flight response, which makes you feel highly alert. Your brain processes movement and your surroundings differently. Your awareness of your body in relation to things around you also changes.

With PPPD, your perception doesn’t go back to normal, which causes disorienting symptoms. You continue to feel highly aware of your balance and body in space, making your symptoms even worse.

Risk Factors for PPPD

Risk factors are things that increase your chances of developing persistent postural-perceptual dizziness. You may face a greater risk of PPPD if you have:

• A chronic balance disorder
• Anxiety
• Depression
• High awareness of your body in space
• Migraines

Also, PPPD affects more women than men. It commonly develops in people ages 30 to 50.

We offer in-depth evaluations to diagnose persistent postural-perceptual dizziness. Our experts spend time understanding and learning about what you experience to give you an accurate diagnosis.

Our vestibular balance disorder specialists get a complete understanding of your medical history, current medications, and symptoms. We learn when your symptoms started, how long they last, and how frequently they happen. We also ask what makes your symptoms better and worse and how they impact your life and well-being.

We do specialized tests called vestibular diagnostics to assess the different parts of your balance system. You may get these tests done before or after your initial exam with a clinician. Vestibular diagnostics include:

• Audiogram to assess your hearing ability
• Vestibular evoked myogenic potentials (VEMPs), which measure your muscle activity in response to repetitive sounds
• Video head impulse test (vHIT) and rotary chair (head) test, which measure your ability to stabilize your vision while moving your head
• Videonystagmography (VNG), which checks for involuntary eye movements

Our clinicians do several other tests to learn how PPPD affects you and check for other medical conditions. We learn about your:

• Brain health and thinking abilities
• Eye health and vision
• Gait (how you walk) and posture
• Heart health
• Mental health

Your clinician may order brain imaging tests for more information. For example, you may have a computed tomography (CT) scan or magnetic resonance imaging (MRI). You may also get blood tests to check for other medical conditions that cause symptoms similar to PPPD.