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Related Experiment Video

Updated: Jun 29, 2025

Estimating Vestibular Perceptual Thresholds Using a Six-Degree-Of-Freedom Motion Platform
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Persistent postural-perceptual dizziness: A functional neuro-otologic disorder.

Chihiro Yagi1, Akira Kimura1, Arata Horii1

  • 1Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan.

Auris, Nasus, Larynx
|March 29, 2024
PubMed
Summary

Persistent postural-perceptual dizziness (PPPD) is a common cause of chronic dizziness. Diagnosis involves specific tests and understanding that symptoms are not solely explained by initial triggers.

Keywords:
DiagnosisFunctional dizzinessPPPDReviewTreatmentVestibular test

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Area of Science:

  • Neuroscience
  • Otolaryngology
  • Psychiatry

Background:

  • Persistent postural-perceptual dizziness (PPPD) is the leading cause of chronic vestibular syndrome.
  • Characterized by dizziness, unsteadiness, and vertigo exacerbated by posture, motion, and visual stimuli.
  • Often follows acute vestibular events but symptoms exceed the initial cause.

Purpose of the Study:

  • To define PPPD as a functional neuro-otologic disorder.
  • To outline diagnostic criteria and potential diagnostic tools.
  • To explore pathophysiology and treatment strategies for PPPD.

Main Methods:

  • Review of clinical presentation and diagnostic features of PPPD.
  • Evaluation of specialized tests like head roll-tilt subjective visual vertical and gaze stability tests.
  • Analysis of neuroimaging findings and treatment outcomes.

Main Results:

  • PPPD symptoms are exacerbated by upright posture, motion, and visual stimuli.
  • Specific tests may reveal somatosensory- and visually-dependent spatial orientation.
  • Neuroimaging suggests altered visuo-vestibular, sensorimotor, and emotional network interactions.

Conclusions:

  • PPPD is a distinct functional disorder, not solely a diagnosis of exclusion.
  • Specialized vestibular tests can aid in diagnosing PPPD.
  • Treatment involves pharmacotherapy, vestibular rehabilitation, and cognitive behavioral therapy.