Characteristics of persistent postural perceptual dizziness patients in a multidisciplinary dizziness clinic

Abstract

BACKGROUND: Persistent Postural Perceptual Dizziness (PPPD) is a newly defined condition which was added to the International Classification of Vestibular Disorders in 2017. Little is known about its impact on patients. OBJECTIVE: The goal of this study was to analyze the symptomology, epidemiology and impact of PPPD on patients. METHODS: A retrospective chart review was done to identify patients who attended the Multidisciplinary Dizziness Clinic (MDC) and were diagnosed with PPPD. Responses to demographic questions, health-related quality of life surveys and several well-validated questionnaires commonly used to assess dizziness severity were analyzed. RESULTS: One hundred patients were diagnosed with PPPD between March 2017 and January 2019, of which 80%(80/100) were females. The average Dizziness Handicap Index score was 60.3±19.0. Responses to the Patient Health Questionnaire classified 53 patients (53/99;53.5%) as moderately to severely depressed. Sixty-four patients (64/100;64.0%) were minimally or mildly anxious according to the Generalized Anxiety Disorder scale. The average Vertigo Symptom Scale score was 24.1/60. The average Situational Vertigo Questionnaire score was 2.00. Forty-nine (49/100;49.0%) patients had migraine symptoms according to the Migraine Screen Questionnaire. CONCLUSIONS: In conclusion, patients with PPPD display important handicap and an elevated risk of depression, anxiety and migraines.

The INVEST trial: a randomised feasibility trial of psychologically informed vestibular rehabilitation versus current gold standard physiotherapy for people with Persistent Postural Perceptual Dizziness

“…Since its international classification by the Bárány Society [ 37 ], PPPD is increasingly recognised as the single most common vestibular syndrome in specialised outpatient clinics [ 38 ] and likely represents the vast majority of patients referred to vestibular rehabilitation [ 36 ]. People living with PPPD have poor quality of life, severe dizziness handicap and an elevated risk of anxiety and depression [ 3 , 40 ].…”

Clinical features of persistent postural-perceptual dizziness with isolated otolith dysfunction as revealed by VEMP and vHIT findings

“…The majority of patients with PPPD were female in the present study (female/male ratio: 2.58/1). Previous studies have also reported female preponderance ( 16 – 18 ). When divided into four groups based on VEMP and vHIT findings, isolated otolith dysfunction was the most common, accounting for 44.2% of patients with PPPD.…”

Psychosocial Factors Associated with dizziness and chronic dizziness: a nationwide cross-sectional study

“…Psychosocial factors are also associated with dizziness and chronic dizziness. Previous studies have reported that chronic dizziness is partially related to ‘psychogenic’ causes, and may also cause secondary anxiety or depression [ 14 , 15 ]. Mental disorders, including anxiety disorders, frequently co-occur with balance problems [ 8 , 16 ].…”