What is PPPD Vertigo? Causes, Symptoms, Exercise and Treatment?

PPPD Vertigo is a condition that causes chronic dizziness arising out of vestibular disorders. PPPD symptoms include dizziness without any particular cause, & infrequent unsteadiness brought on by certain environmental or social causes, that are otherwise unexplainable through any other neuro-otological disorders & reasons.

PPPD symptoms are triggered by any pre-existing vestibular illnesses, a medical illness whether diagnosed or undiagnosed, & psychological stress. Early signs of PPPD Vertigo include possessing an obsessive-compulsive personality, being diagnosed with mental illnesses such as mild depression & anxiety. However, even though PPPD Vertigo presents itself with symptoms akin to a psychiatric illness, it is primarily a neuro-otological disorder with certain behavioral elements to it.

Further medical researches into What is PPPD, PPPD causes, & PPPD Symptoms led medical experts to find that PPPD symptoms also included non-vertiginous dizziness & general unsteadiness that is either triggered by or worsened  by external environmental stimuli & performing tasks that require a precise degree of concentration such as reading, writing, & computer programming. 

PPPD Vertigo can also present itself as space-motion discomfort, along with visual vertigo, symptoms that overlap those of Peripheral Vertigo & Chronic Subjective Dizziness. We’ll read more about PPPD Vertigo, PPPD causes, PPPD symptoms, PPPD treatment, & PPPD vertigo medicine in the following paragraphs. 

What is PPPD Vertigo?

PPPD Vertigo is a condition characterized by chronic dizziness that is caused by vestibular disorders.

PPPD Vertigo patients often show a range of behavioral symptoms such as obsessive-compulsive disorder, mild depression, & a rise in general anxiety levels. 

Phobic Postural Vertigo & Dizziness was first explained by two renowned German neurologists, Thomas Brandt & Marianne Dieterich, as a condition of postural  non-vertiginous dizziness with frequently recurrent dizzy episodes.  Medical researches around the world have performed scientific studies on the concept of PPPD Vertigo & have concluded it to be a combination of Chronic Subjective Dizziness (CSD) & PPV, terming the condition collectively as Persistent Postural Perceptual Dizziness or PPPD Vertigo.

PPPD Symptoms

One of the most common symptoms of Persistent Postural Perceptual Dizziness(PPPD) are recurring sensations of rocking & swaying unsteadiness, along with dizziness without Vertigo that lasts more than 3 months. 

Another common giveaway of PPPD Vertigo is that the patient experiences symptoms on a daily basis.

PPPD Symptoms also worsen with:

  • Sitting or standing in an upright posture,
  • Any head or body motions,
  • Constant exposure to complex & motion-rich environments

PPPD Symptoms also typically start with an episode of acute Vertigo, unsteadiness, dizziness, & disorientation of balance including:

  • A central or peripheral Vestibular disorder, for eg., BPPV, Vestibular Neuritis, Meniere’s Disease, & stroke. 
  • Vestibular Migraine,
  • Panic attacks that occur along with dizziness,
  • Mild to traumatic brain injury, whether through a concussion or whiplash
  • Dysautonomia, which is a disease of the autonomic nervous system

Other medical problems like dysrhythmias, & certain drug reactions that present themselves with acute episodes of Vertigo, unsteadiness, & dizziness problems are not exactly symptoms of PPPD Vertigo. 

In most cases, PPPD Vertigo starts with a physical trigger, although it might not be immediately visible. 

Patients also show mild depression & anxiety, although these aren’t as much of PPPD symptoms as they are PPV symptoms. The most common & striking PPPD Symptom is the patients’ psychological inability to face their triggers. Most PPPD Vertigo patients feel as if they will be in terrible danger if they step into situations that happen to trigger their PPPD symptoms.  This psychological aspect of symptoms is notably seen in PPPD Vertigo as compared to any other types of Vertigo. 

PPPD Treatment

Medical researchers have arrived at a detailed PPPD Vertigo Treatment based on a patient’s individual symptoms, medical history, & personalized presentation of PPPD symptoms. PPPD treatment includes PPPD vertigo medicines, PPPD treatment therapies, & vestibular rehabilitation exercises to help the patient feel relief from their symptoms. 

PPPD Vertigo Medicines

Your healthcare provider might prescribe SSRIs (Selective Serotonin Reuptake Inhibitors) & SNRIs (Serotonin Norepinephrine Reuptake Inhibitors) to relieve you of Chronic Dizziness symptoms of PPPD Vertigo. PPPD Vertigo treatment with SSRIs & SNRIs has a marked reputation for being successful most of the time. Patients who are prescribed SSRIs for PPPD treatment show about 70-80% decline in their primary PPPD symptoms, along with showing improvement in recurrent dizziness & comorbid anxiety & depression. 

However, it is important to continue the treatment for at least a year to produce the desired effect. 

It is also important to know that benzodiazepines & other vestibular suppressants are not effective for PPPD treatment. 

Vestibular Balance Rehabilitation Therapy

Vestibular Balance rehabilitation Therapy helps in PPPD treatment by making the patients feel more habituated & desensitized to PPPD symptoms & triggers. Since most cases of PPPD Vertigo are triggered or worsened by external motion stimuli, VRT is targeted at helping the patients get accustomed to motion stimuli & other PPPD symptoms.  Medical researchers peg the efficacy of Vestibular Balance Rehabilitation Therapies as PPPD treatment at about 60-80%, depending on each patient’s individual symptoms & medical history.

VRT helps increase the mobility & daily functioning of PPPD Vertigo patients by a considerable amount. 

It is also credited with reducing the anxiety & depression of PPPD Vertigo patients, by helping them become more independent regarding daily activities & environmental motion stimuli.  Vestibular Balance Rehabilitation Therapy for PPPD Vertigo treatment should be continued for at least 3-6 months to reap the maximum benefits of it. 


Psychotherapy & related counseling can help in the early stages of PPPD vertigo treatment, but not if the patient has fully developed, long standing PPPD symptoms. Research also showed that Cognitive Behavioral therapy (CBT) helped reduce recurrent dizziness in patients with PPPD symptoms. 

However, this relief didn’t last long once the therapy finished.  Recent researches conducted in the realm of PPPD Vertigo treatment & the efficacy of CBT concluded that patients show signs of relief from dizziness & related psychological distresses in just 3 sessions when the therapy is started within 8 weeks from when the patient first experiences PPPD symptoms. 

Research & studies have also shown that in patients who experience debilitating anxiety, the likelihood of developing PPPD Vertigo were 60% in those who had clinically significant anxiety, 45% in those who had clinically significant depression, & 25% in patients who had neither. 

Anxiety medications & therapies to reduce general anxiety levels in patients can also help in reducing the recurring dizziness & unsteadiness among them. 

Balance exercises and habituation exercises are also noted for helping PPPD patients desensitize and get used to external stimulation due to any kind of motion and complex sensory environments. 

Vestibular rehabilitation therapy consists of a set of customized physical exercises according to the patient’s needs.  It includes a variety of eye movements, head & body exercises, to optimize vestibular compensation from the PPPD symptoms.  NeuroEquilibrium range of clinics has developed an effective line of treatment using virtual reality technology to reduce visual vertigo symptoms in PPPD Vertigo patients. PPPD patients have shown to benefit greatly from this treatment module.

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