Citation

Kaski D. J. Laryngol. Otol. 2024; 138(S2): S27-S31.

Copyright

(Copyright © 2024, JLO Ltd., Publisher Cambridge University Press)

DOI

10.1017/S0022215123002153

PMID

38779894

Abstract

OBJECTIVE: Persistent postural-perceptual dizziness classifies patients with chronic dizziness, often triggered by an acute episode of vestibular dysfunction or threat to balance. Unsteadiness and spatial disorientation vary in intensity but persist for over three months, exacerbated by complex visual environments.

METHOD: Literature suggests diagnosis relies on a clinical history of persistent subjective dizziness and normal vestibular and neurological examination findings. Behavioural diagnostic biomarkers have been proposed, to facilitate diagnosis.

RESULTS: Research has focused on understanding the neural mechanisms that underpin this perceptual disorder, with imaging data supporting altered connectivity between neural brain networks that process vision, motion and emotion. Behavioural research identified the perceptual and motor responses to a heightened perception of imbalance.

CONCLUSION: Management utilises head and body motion detection, and downregulation of visual motion excitability, reducing postural hypervigilance and anxiety. Combinations of physical and cognitive therapies, with antidepressant medications, help if the condition is associated with mood disorder.

Language: en

Keywords

*Dizziness/therapy/diagnosis/physiopathology; *Postural Balance/physiology; Chronic Disease; diagnosis; Humans; Inner ear; neuro-otology; postural balance; vertigo; Vestibular Diseases/diagnosis/therapy/physiopathology/complications