Decoding PPPD: Navigating Chronic Dizziness
A patient of mine was recently presented with symptom of dizziness. My diagnosis was Persistent Postural-Perceptual Dizziness (PPPD).PPPD is relatively “recent” diagnosis. PPHD will be listed in the upcoming International Classification of Disease (ICD-11) .ICD-11 is a system of medical coding. This coding is created by the World Health Organization (WHO).The coding has been created for documenting:
- diagnoses
- diseases
- signs and symptoms
- and social circumstances
Just in Your Head!
These are exciting times for patients who suffer this condition. Prior to the PPPD listing patients were told their problem was in their mind... a psychiatric or psychological problem underlying their dizziness.These times are just as exciting for health practitioners... we can achieve better outcomes for our patients.I feel relief for the patients who suffer the disease… often they feel guilty for their problem due to it's “psychogenic” label.The treatment options for a psychogenic diagnosis are limited... except for psychogenic drug therapy, which most are unwilling to take.There has been no objective tests for anatomical or physiological “abnormalities”.PPPD patients have normal values in clinical balance tests.Simply put, if we can’t find anything wrong with you, it must be in your head.
A Mismatch Between Perception and Expectation
We now know PPPD is one of the most common causes of chronic dizziness in middle-aged patients... this chronic dizziness impacts activities of daily living and functionality.PPPD is based on the clinical condition of Phobic Postural Vertigo (PPV).... which in concept is a derangement in the sensorimotor function or a neural mismatch.There’s a mismatch between perception and expectation... the sensory inputs perceiving our environment and our pattern of expectation- our balance.Thus, our perception of head motion or body sway is inaccurate... causing the sensation of feeling off balance.
Symptoms of PPPD
Common symptoms of PPPD are:
- Dizziness, unsteadiness , non-spinning.
- Vertigo that is present on most days for a period of 3 months or more.
- Experience of benign dizziness brought on by movement in their environment... typically worse in an upright position
The symptoms tend to start shortly after an event that causes acute vertigo ie:
- peripheral or central vestibular disorder
- vestibular migraine
- panic attack with dizziness
- mild traumatic brain injury (concussion/ whiplash)
If you are suffering any of the above symptoms please contact Dr Tio on 1300 432 639. As a Chiropractor with a special interest in the area of neurology she would be happy to put your mind at ease… and steer you down the path of recovery.
