Persistent postural-perceptual dizziness: a phenotype-oriented approach to practical management
Abstract
Introduction: Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder defined by persistent dizziness, unsteadiness, or non-spinning vertigo exacerbated by upright posture, active or passive motion, and visually complex environments. In clinical practice, however, the diagnostic label alone is often insufficient to guide management, because patients differ substantially in the relative prominence of visual dependence, motion-postural burden, multisensory provocation, affective-hypervigilant mechanisms, and migraine overlap.
Objective: To propose a clinically oriented, dimension-informed framework for translating a positive diagnosis of PPPD into individualized formulation and practical multimodal management.
Methods: This article presents a practice-oriented narrative synthesis rather than a systematic review or formal guideline. The literature was selected to inform clinical formulation, symptom profiling, assessment, treatment prioritization, and the interface between PPPD and vestibular migraine. The proposed framework is intended as a pragmatic clinical heuristic, not as a biologic taxonomy or a validated treatment-stratification model.
Conclusion: We organize PPPD heterogeneity around five anchor clinical phenotypes: visually dominant/visually dependent, active motion-postural, mixed/multisensory, affective-hypervigilant, and migraine-overlap/vestibular migraine-PPPD interface. These patterns are best understood as dominant clinical…
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.