Soumyajit Das1, Chandra Sekhar Annam2, Satvinder Singh Bakshi2, Ramesh Seepana3. 1. Department of ENT, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, 522503, India. drsoumya_entamch@rediffmail.com. 2. Department of ENT, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, 522023, India. 3. Department of ENT, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, 522503, India.
Abstract
INTRODUCTION: Dizziness is an important symptom presenting in routine practice and the life time prevalence ranges from 17 to 30%. Persistent positional perceptual dizziness (PPPD) is a common cause of chronic dizziness and has often been labeled as psychogenic dizziness in the past. DISCUSSION: PPPD is diagnosed based on clinical criteria laid down by the Barany society. The vestibular function tests and imaging of the brain and the inner ear are often normal. Most of the patients have an underlying anxiety trait and most cases of PPPD arise following an attack of acute vertigo like Meniere's disease and vestibular neuritis. It is important to differentiate the condition from bilateral vestibulopathy. There is no role of vestibular sedative in the treatment of such condition. Vestibular rehabilitation therapy (VRT), cognitive behavioral therapy (CBT), and selective serotonin reuptake inhibitors (SSRI) like sertraline have shown benefits. However, long-term outcome is not known. CONCLUSION: PPPD is a relatively new entity in the ever-expanding field of neurotology that requires a multimodality approach for effective management. The otologists and general physicians must identify the condition so that favorable outcome can be achieved. The long-term effects of treatment with CBT and VRT are not known. It is important to formulate standard guidelines for treatment. Further research is necessary to identify the role of endogenous biomarkers in the outcome of treatment.
INTRODUCTION: Dizziness is an important symptom presenting in routine practice and the life time prevalence ranges from 17 to 30%. Persistent positional perceptual dizziness (PPPD) is a common cause of chronic dizziness and has often been labeled as psychogenic dizziness in the past. DISCUSSION: PPPD is diagnosed based on clinical criteria laid down by the Barany society. The vestibular function tests and imaging of the brain and the inner ear are often normal. Most of the patients have an underlying anxiety trait and most cases of PPPD arise following an attack of acute vertigo like Meniere's disease and vestibular neuritis. It is important to differentiate the condition from bilateral vestibulopathy. There is no role of vestibular sedative in the treatment of such condition. Vestibular rehabilitation therapy (VRT), cognitive behavioral therapy (CBT), and selective serotonin reuptake inhibitors (SSRI) like sertraline have shown benefits. However, long-term outcome is not known. CONCLUSION: PPPD is a relatively new entity in the ever-expanding field of neurotology that requires a multimodality approach for effective management. The otologists and general physicians must identify the condition so that favorable outcome can be achieved. The long-term effects of treatment with CBT and VRT are not known. It is important to formulate standard guidelines for treatment. Further research is necessary to identify the role of endogenous biomarkers in the outcome of treatment.
Authors: G Chiarella; C Petrolo; R Riccelli; L Giofrè; G Olivadese; F M Gioacchini; A Scarpa; E Cassandro; L Passamonti Journal: J Vestib Res Date: 2016-11-03 Impact factor: 2.435
Authors: Iole Indovina; Roberta Riccelli; Giuseppe Chiarella; Claudio Petrolo; Antonio Augimeri; Laura Giofrè; Francesco Lacquaniti; Jeffrey P Staab; Luca Passamonti Journal: Front Behav Neurosci Date: 2015-12-09 Impact factor: 3.558
Authors: Hayo A Breinbauer; Maria Daniela Contreras; Juan P Lira; Claudia Guevara; Leslie Castillo; Katherine Ruëdlinger; Daniel Muñoz; Paul H Delano Journal: Front Neurol Date: 2020-01-09 Impact factor: 4.003