Persistent postural-perceptual dizziness (PPPD), previously known as Chronic Subjective Dizziness (CSD), is a condition characterized by persistent feelings of dizziness, unsteadiness, and/or imbalance that are typically provoked or worsened by upright posture, active or passive motion, and exposure to complex or visually stimulating environments. Individuals with PPPD often report symptoms such as feeling like they are swaying, rocking, floating, or bobbing, even when they are standing still.

PPPD is thought to result from a complex interplay of factors involving sensory integration, central nervous system processing. It is not a psychiatric disorder. It may develop following an acute vestibular disorder, such as vestibular neuritis or labyrinthitis, but can also arise independently or be triggered by other factors such as migraine, anxiety, or a cardiovascular event.

Diagnosis of PPPD is based on clinical symptoms and medical history, as there are no specific diagnostic tests for the condition. Healthcare providers may perform a thorough evaluation to rule out other potential causes of dizziness and balance problems.

Treatment for PPPD typically involves a multidisciplinary approach, including vestibular rehabilitation therapy to improve balance and reduce symptoms, cognitive-behavioral therapy (CBT) to address maladaptive coping strategies, medications, and lifestyle modifications. The goal of treatment is to help individuals manage their symptoms and improve their quality of life.

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