Department of Neurology, College of Medicine, Ewha Womans University, Mokdong Hospital, Seoul, Korea
Copyright © 2020 by The Korean Balance Society
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Criteria for the diagnosis of Persistent Postural-Perceptual Dizziness (PPPD) [6]
A.One or more symptoms of dizziness, unsteadiness, or nonspinning vertigo are present on most days for 3 months or more. 1.Symptoms last for prolonged (hourslong) periods of time, but may wax and wane in severity. 2.Symptoms need not be present continuously throughout the entire day. B.Persistent symptoms occur without specific provocation, but are exacerbated by 3 factors 1.Upright posture, 2.Active or passive motion without regard to direction or position, and 3.Exposure to moving visual stimuli or complex visual patterns. C.The disorder is precipitated by conditions that cause vertigo, unsteadiness, dizziness, or problems with balance including acute, episodic, or chronic vestibular syndromes, other neurologic or medical illnesses, or psychological distress. 1.When the precipitant is an acute or episodic condition, symptoms settle into the pattern of criterion A as the precipitant resolves, but they may occur intermittently at first, and then consolidate into a persistent course. 2.When the precipitant is a chronic syndrome, symptoms may develop slowly at first and worsen gradually. D.Symptoms cause significant distress or functional impairment. E.Symptoms are not better accounted for by another disease or disorder. |
Differential diagnosis of persistent postural-perceptual dizziness
Chronic sequelae of acute precipitants Recurrent attacks of episodic precipitants Ongoing manifestations of chronic precipitants Chronic anxious and depressive disorders Postconcussion syndrome Disorders of autonomic nervous system Bilateral vestibulopathy Neurodegenerative diseases; parkinsonism, cerebellar degeneration, downbeat nystagmus syndrome Mal de Debarquement syndrome Medical or psychiatric disorders that produce persistent unsteadiness or dizziness Adverse effects of medications |