A Clear Guide to PPPD
Comprehensive Support for PPPD
Persistent dizziness without spinning? PPPD is a common vestibular disorder triggered by prior events, manageable with targeted therapy, and not a sign of serious illness. At Harley AVM, our team effectively guides recovery. Seek urgent AVM care for sudden, severe headache, vision loss, weakness, slurred speech, or numbness. These high-risk symptoms need immediate evaluation.
Comprehensive Care for Hearing, Vertigo & Balance
Comprehensive Care for Hearing, Vertigo & Balance
Persistent Balance Processing Disorder
An Overview of PPPD
Persistent Postural-Perceptual Dizziness (PPPD) is a chronic balance condition characterised by ongoing dizziness, unsteadiness, or non-spinning vertigo that persists most days for months. Symptoms often feel worse when standing or walking, in visually busy environments, or during active movement, even though routine balance tests may appear normal.
PPPD usually develops after an initial balance event such as vestibular neuritis, BPPV, migraine, or a period of significant stress. The condition reflects altered brain processing of balance and spatial signals rather than ongoing inner-ear damage. Although symptoms can be distressing and long-lasting, PPPD is a recognised diagnosis. Identifying it accurately allows structured, targeted management aimed at restoring balance, confidence and daily function.
OUR REVIEW
Trusted by Patients,
Proven by Results
EXCELLENT Based on 105 reviews Posted on shahram zarafshanTrustindex verifies that the original source of the review is Google. Dr. Arun Pajaniappane is a brilliant and expert doctor. He was also incredibly friendly, making for a truly excellent experience.Posted on Vasile BaltacTrustindex verifies that the original source of the review is Google. I had an excellent consultation where both the doctor Arun Pajaniappane and the audiologist were highly professional, attentive, and genuinely responsive to my concerns. They listened carefully to my problems and explained everything clearly throughout the appointment. The procedures carried out were handled with great care and efficiency, which made me feel comfortable and well looked after. I very much appreciated their professionalism and patient-centred approach.Posted on Carol lansleyTrustindex verifies that the original source of the review is Google. My first consultation with Dr Arun Pajaniappane was an excellent experience. He listened carefully to me & did extensive tests to try to determine the correct diagnosis.Posted on Dawn MannTrustindex verifies that the original source of the review is Google. my experience from the first phone call to meeting with Dr Arun on Monday has been outstanding. i have been suffering for four years with PPPD and Dr Arun and his team were beyond respectful, helpful and friendly, after feeling totally lost for the last four years being thrown from one HCP to another, I now have hope. Amazing experience and would strongly recommend Dr Arun and this practice for any vestibular disorders.Posted on Nick2015Trustindex verifies that the original source of the review is Google. Very good service efficient booking and profesional approachPosted on Jamie CodringtonTrustindex verifies that the original source of the review is Google. Fantastic carePosted on Ana KondratenkoTrustindex verifies that the original source of the review is Google. Great experience at Harley AVM. Attended the clinic to have vestibular tests conducted - high professionalism and comfort!Posted on Monika HlavkovaTrustindex verifies that the original source of the review is Google. A really good experience with the whole clinic - quick and efficient booking process, coordination between various teams, and generally a smooth operation. The consultation with Dr Rudy was very informative - he takes the time to understand the issue and answer questions, the tests seem to be very comprehensive and he is clear on the path forward. Would definitely recommend.Posted on Hughie ClarkTrustindex verifies that the original source of the review is Google. I recommend Harley AVC for anyone struggling with dizziness/pppd who isn’t sure what their next steps should be
Pinpointing the Cause
Diagnosing PPPD
When to Get Checked
You should get assessed if ongoing dizziness or unsteadiness lasts for several weeks, feels worse when standing, walking, or in visually busy environments, or follows a previous balance episode such as vertigo, migraine, or illness. Symptoms that persist despite reassurance or normal test results also warrant audiovestibular review.
You should seek urgent assessment if dizziness begins suddenly with new neurological symptoms, severe headache, weakness, speech difficulty, visual loss, or repeated falls. Early evaluation helps exclude other causes and ensures appropriate support and management.
How We Assess PPPD
At Harley Audiovestibular Clinic, our senior audiovestibular healthcare professional begins by taking your detailed history and exploring dizziness, persistence, triggers, unsteadiness, and prior events to confirm PPPD diagnostic criteria. We prioritise unhurried consultations with our consultants to deeply understand your experience for accurate profiling.
We proceed with balance testing, gait analysis, and questionnaires to rule out alternative diagnoses, followed by a collaborative review of results. Our senior team integrates these insights for a holistic diagnosis. This structured pathway sets us apart, enabling personalised rehabilitation plans that effectively rebuild stability and confidence. At Harley AVM, our focus is on delivering lasting recovery through expert care. We empower you with clear next steps and ongoing support tailored just for you.
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DIAGNOSTIC TESTS
Specialist Tests to Assess Hearing, Balance and Inner Ear Health
FAQS
Common Questions for PPPD
Find answers to PPPD, treatment options, and how our specialists can help. If you have any further queries, our team at Harley Street Audiovestibular Clinic is here and happy to help.
Is PPPD Just Another Name for Anxiety
Psychological factors including anxiety and depression can contribute to the development and triggering of PPPD. However, there could be an underlying physical cause to symptoms which requires to be investigated and identified by a qualified vestibular specialist medical doctor. . PPPD can affect both men and women of any age, although it tends to be more common in people under the age of 50.
What Are the Symptoms of PPPD?
Symptoms can vary slightly from person to person. Some describe a feeling that their insides are in motion even while they are standing or sitting still. Others describe a sense of being in a boat that is rocking on the ocean. While still others describe their body swaying while they’re otherwise still. At Harley Street AVM we often encounter patients who talk of feeling “drunk” although they have not consumed alcohol. A sense of physical detachment from reality is also fairly common. Patients can experience brain fog, difficulty with concentration, disorientation and intolerance to busy environments such as supermarkets.
What Causes PPPD?
PPPD almost never occurs as a stand-alone condition. In the majority of cases, people begin to experience PPPD in the aftermath of some other event, such as a vestibular migraine, vestibular neuritis or BPPV. It may also occur in the aftermath of a traumatic event such as a violent car crash or other physical or psychological trauma. There could be a persistent underlying inner ear or brain abnormality which drives the PPPD.
How Is PPPD Diagnosed?
PPPD is a diagnosis of exclusion. That means that it can be only diagnosed after a specialist doctor takes a detailed history, undertakes a full examination and, after you have had appropriate tests and scans to rule out other conditions. There are currently no diagnostic tests that can confirm the presence of PPPD.
Is Treatment Available for PPPD?
While there is no quick fix, there are treatment options available that can help. Over time it is possible to manage symptoms to such a degree that the person can once again experience a more or less normal life. But it will take time. Medication, Physiotherapy, desensitisation therapy, and psychological treatment when used in concert with one another have been known to produce beneficial results.
Harley Street Specialists in Hearing, Dizziness & Balance
Specialist Care for PPPD
Every PPPD case is different. Your consultant will create a tailored plan to address your specific symptoms and lifestyle – when it started, how it affects your day, and which tests and treatments are right for you.