PPPD stands for Persistent Postural Perceptual Dizziness. It is a chronic condition that manifests as near constant dizziness that can have a negative impact on a person’s overall quality of life. The cause of PPPD can usually be traced to a triggering event and requires detailed assessment by a specialist vestibular medical doctor. Those triggers can include:

  • Vertigo
  • BPPV
  • Vestibular migraine
  • Head injury
  • Panic attacks
  • Meniere’s disease
  • Stroke
  • Migraines and more.

What Happens When You Experience PPPD?

The human balance system is complex and sophisticated and composed of numerous parts including the eyes, inner ear, brain and muscles. Countless bits of information are processed every second that enable us to stay upright and stable.

With PPPD, however, people experience a breakdown within that complex system whereby the various parts are no longer communicating in a harmonious manner. When such disconnects occur the person feels unsteady on their feet, and experience constant sway, imbalance or rocking sensation as if on a boat. .

Common Symptoms of PPPD

PPPD is a chronic condition, meaning the person will experience it most (but not necessarily all) days and it tends to occur most of the time  You can also experience exacerbation with dizzy episodes which may last several hours or it may come and go quickly, only to return in an unpredictable fashion.

Many people with PPPD describe feeling like they are standing on a rocking boat. This sensation can be made more acute by movement, or changing positions quickly or being in a setting where there is a lot going on visually.

Risk Factors for PPPD

Any inner ear disorder such as BPPV, Meniere’s disease, endolymphatic hydrops, vestibular neuritis or labyrinthitis can lead to PPPD. Migraine, vestibular migraine and head trauma may also lead to the development of PPPD.In addition, studies indicate that people suffering from anxiety or depression may be more susceptible to developing PPPD than others.


PPPD can be difficult to diagnose because the balance system comprises so many parts. That’s why, if you suspect you have PPPD, you need to see a qualified medical vestibular specialist such as an Audiovestibular Physician. They will perform a comprehensive assessment of your condition and determine if the problem is PPPD or something else and exclude serious conditions such as brain tumours.

Harley St AVM for PPPD Diagnosis & Treatment

PPPD can seriously undermine a person’s quality of life. If you suspect you may be experiencing PPPD contact Harley St AVM for expert diagnosis and treatment.