Persistent Postural-Perceptual Dizziness: Precipitating Conditions, Co-morbidities and Treatment With Cognitive Behavioral Therapy

John Waterston; John Waterston; Luke Chen; Luke Chen; Kate Mahony; Jamila Gencarelli; Geoff Stuart; Geoff Stuart

doi:10.3389/fneur.2021.795516

Frontiers in Neurology (Dec 2021)

Persistent Postural-Perceptual Dizziness: Precipitating Conditions, Co-morbidities and Treatment With Cognitive Behavioral Therapy

John Waterston,
John Waterston,
Luke Chen,
Luke Chen,
Kate Mahony,
Jamila Gencarelli,
Geoff Stuart,
Geoff Stuart

Affiliations

John Waterston: Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
John Waterston: Oto-Neurology Department, Alfred Hospital, Melbourne, VIC, Australia
Luke Chen: Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
Luke Chen: Oto-Neurology Department, Alfred Hospital, Melbourne, VIC, Australia
Kate Mahony: Private Practice, Lyttleton Street Medical Clinic, Castlemaine, VIC, Australia
Jamila Gencarelli: Oto-Neurology Department, Alfred Hospital, Melbourne, VIC, Australia
Geoff Stuart: Department of Cognitive Science, Macquarie University, Sydney, NSW, Australia
Geoff Stuart: School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia

DOI: https://doi.org/10.3389/fneur.2021.795516
Journal volume & issue: Vol. 12

Abstract

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Persistent postural perceptual dizziness (PPPD) is a common chronic vestibular disorder characterized by persistent vestibular symptoms, including postural instability and non-spinning vertigo, which is aggravated by motion, upright posture and moving or complex visual stimuli. In our review of 198 cases seen over a 5 year period, we have confirmed a number of common precipitating conditions for PPPD, including anxiety disorders and vestibular migraine. Vestibular abnormalities, including a unilateral loss of vestibular hypofunction and isolated otolith abnormalities, were found on investigation in just under half the cases. The use of cognitive behavioral therapy (CBT) as a treatment for PPPD resulted in impressive reductions in anxiety and measures of dizziness over follow up periods of up to 6 months.

Published in Frontiers in Neurology

ISSN: 1664-2295 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.frontiersin.org/journals/neurology/

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