Persistent Postural Perceptual Dizziness
So what is PPPD?
PPPD is a term now acknowledged since 2015 as Persistent Postural Perceptual Dizziness. It is a common cause of long lasting dizziness or non spinning vertigo. It may give the sense of rocking or swaying even when you are standing still. It usually is diagnosed after 3 months of persistent symptoms. It can be through a process of elimination to exclude any structural vestibular dysfunction or other disease process that could more likely explain symptoms.
It can often follow an acute vestibular event, medical illness or psychological stress. Some examples are BPPV, Meniere’s disease, Vestibular Migraine, Vestibular Neuritis, Concussion or Generalised Anxiety Disorders, Panic attacks. Instead of fully recovering the brain stays on high alert and overreacts. It is like when something that should be in the background of the computer (like our brain) comes up to the desktop. Anxiety can develop around any movement that can bring on symptoms. It can be very distressing as it impacts daily living. It can be a vicious cycle.
Symptoms can fluctuate in intensity, usually worsened by movements when upright or walking. Once quietly sitting or lying symptoms can improve. Complex visual scenarios can be triggering like walking through crowded places, scanning supermarket aisles, looking at patterned carpets.
Treatment includes retraining the brain’s perception of movement and balance. This can be through vestibular rehabilitation, medication and counselling. Physiotherapy specialising in vestibular can help desensitise the brain to movement, treat any tension building in the neck and provide support on the road to recovery. Balance is made up of inputs form the visual system, the vestibular system and the proprioception system. Exercises try and tone down brains reactivity and high alert state. Progress is slow and steady, it takes patience and time to heal.
If that sounds like something you have been struggling with you are not alone it is more common than people think.
Treatment can help provide relief and the earlier the better.
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Book online or give us a call on 1300MyHeadache (1300 694 323) to organise an assessment with Sydney Headache & Migraine Centre and learn more about what causes your migraines and how we can help treat them.
