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Equilibrium and Balance

Equilibrium and Balance

The inner ear assumes dual functionalities of auditory perception and equilibrium maintenance. The vestibule is the organ responsible for balance. This organ contains mechanoreceptors, specifically hair cells, endowed with stereocilia, which aid in deciphering information regarding the position and motion of our heads. Two intrinsic components, the utricle and saccule, help perceive head position, while the semicircular canals track head movement. Neurological messages initiated in the...

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Related Experiment Video

Updated: Aug 31, 2025

Estimating Vestibular Perceptual Thresholds Using a Six-Degree-Of-Freedom Motion Platform

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Published on: August 4, 2022

Persistent positional perceptual dizziness in clinical practice: a scoping review.

Soumyajit Das¹, Chandra Sekhar Annam², Satvinder Singh Bakshi²

¹Department of ENT, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, 522503, India. drsoumya_entamch@rediffmail.com.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

|August 22, 2022

Summary

Persistent positional perceptual dizziness (PPPD) is a common cause of chronic dizziness. Management involves vestibular rehabilitation therapy (VRT), cognitive behavioral therapy (CBT), and SSRIs, though long-term outcomes require further study.

Keywords:

Anxiety Biomarkers Chronic subjective dizziness Depression Diagnosis Dizziness Persistent positional perceptual dizziness Posturography Vestibular rehabilitation

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Area of Science:

Neurotology
Vestibular Disorders
Psychosomatic Medicine

Background:

Dizziness affects 17-30% of the population, with Persistent Positional Perceptual Dizziness (PPPD) being a frequent cause of chronic dizziness.
PPPD was previously misdiagnosed as psychogenic dizziness.
PPPD diagnosis relies on specific clinical criteria, often with normal vestibular and imaging tests.

Purpose of the Study:

To highlight Persistent Positional Perceptual Dizziness (PPPD) as a distinct neurotological entity.
To outline diagnostic criteria and management strategies for PPPD.
To emphasize the need for early identification and further research into PPPD.

Main Methods:

Diagnosis based on Barany society clinical criteria.
Exclusion of other vestibular disorders.
Assessment of underlying anxiety traits and triggers like Meniere's disease or vestibular neuritis.

Main Results:

Vestibular function tests and brain/inner ear imaging are typically normal in PPPD patients.
Anxiety traits are common, and PPPD often follows acute vertigo episodes.
Vestibular rehabilitation therapy (VRT), cognitive behavioral therapy (CBT), and SSRIs show promise in treatment.

Conclusions:

PPPD requires a multimodal management approach, involving otologists and general physicians.
Differentiating PPPD from bilateral vestibulopathy is crucial.
Long-term treatment outcomes and the role of biomarkers need further investigation, necessitating standardized guidelines.