Resources
Glossary
The working vocabulary of PPPD. Inline dotted terms throughout the chapter link here.
- Chronic subjective dizziness (CSD)
- Staab and Ruckenstein's syndrome of persistent non-vertiginous dizziness with hypersensitivity to motion and visual stimuli — the other main precursor merged into PPPD.
- Cognitive behavioural therapy (CBT)
- A structured psychological therapy that targets the fear, avoidance and hypervigilance perpetuating PPPD; even brief courses reduce symptoms.
- Comorbid anxiety
- Anxiety and depression are common in PPPD and amplify symptoms, but they are neither necessary for the diagnosis nor its sole cause — PPPD is a disorder of postural-perceptual function in its own right.
- Functional disorder
- A condition in which symptoms arise from altered functioning of the nervous system rather than from structural damage — genuine and disabling, and diagnosed on positive features, not merely by exclusion.
- High-risk postural-control strategy
- A stiffened, over-cautious mode of standing and walking — tightened co-contraction and reliance on ankle strategy — adopted after a frightening vestibular event and maladaptively retained in PPPD.
- Niigata PPPD Questionnaire (NPQ)
- A validated 12-item questionnaire that quantifies symptom severity across the three exacerbating factors and tracks change with treatment.
- Persistent postural-perceptual dizziness (PPPD) · functional dizziness
- A chronic functional vestibular disorder of persistent non-spinning dizziness or unsteadiness, present on most days for three months or more, exacerbated by upright posture, by movement, and by complex or moving visual environments.
- Phobic postural vertigo (PPV)
- Brandt and Dieterich's syndrome of subjective unsteadiness with normal examination, often attack-like and situation-bound — one of the historical precursors that were unified into PPPD.
- Precipitating event
- The acute or episodic trigger that commonly initiates PPPD — vestibular neuritis or BPPV, vestibular migraine, a panic attack, whiplash or concussion, or another medical event causing dizziness.
- Space-and-motion discomfort
- Discomfort and disorientation provoked by environments with conflicting or sparse spatial cues (supermarket aisles, crowds, traffic) — a characteristic feature linked to visual dependence.
- SSRI / SNRI
- Serotonergic antidepressants (e.g. sertraline, venlafaxine) used at therapeutic doses for PPPD irrespective of overt depression; benefit builds over weeks and is often partial.
- The three exacerbating factors
- Upright posture, active or passive self-motion (regardless of direction), and exposure to moving or complex visual stimuli — the trio that worsens PPPD and anchors criterion B.
- Vestibular rehabilitation (VRT)
- Graded habituation and balance retraining that re-establishes normal automatic postural control and reduces visual dependence — a first-line treatment for PPPD.
- Visual dependence
- Over-reliance on vision for spatial orientation and balance, so that busy or moving visual scenes provoke symptoms (visual vertigo). A core mechanism and a rehabilitation target in PPPD.
- Visual vertigo
- Dizziness and disorientation triggered specifically by demanding visual surroundings — scrolling screens, patterned floors, traffic — reflecting visual dependence.