It's All in Your Head: A Case Report of Persistent Postural-Perceptual Dizziness and Chronic Anxiety Treated Simultaneously With Osteopathic Cranial Manipulative Medicine

Persistent postural-perceptual dizziness is a chronic functional vestibular disorder characterized by persistent dizziness, imbalance, motion sensitivity, and significant psychological distress, frequently including anxiety. Symptoms often persist despite normal imaging and multidisciplinary evaluation, contributing to diagnostic uncertainty and misattribution to psychiatric causes....

No actionable change — a single case report is insufficient evidence to recommend osteopathic cranial manipulative medicine for PPPD; audiologists managing PPPD patients should continue following established vestibular rehabilitation and CBT-based guidelines.

PPPD is increasingly recognized in vestibular audiology practice, and non-pharmacological treatment options are of growing interest, but single case reports cannot establish efficacy or safety of novel interventions.

1. 01Single case report (N=1); lowest level of clinical evidence.
2. 02Patient had concurrent PPPD and chronic anxiety treated with osteopathic cranial manipulative medicine (OCMM).
3. 03PPPD is a functional vestibular disorder characterized by persistent non-spinning dizziness and postural instability.
4. 04No control, no standardized outcome measures reported, and no comparison to established PPPD treatments.
5. 05Findings cannot be generalized; vestibular rehabilitation and SSRIs/SNRIs remain the evidence-based standard for PPPD.

PMID

42434628

DOI

10.7759/cureus.110597.

Journal

Cureus

Publication type

case_report

Evidence level

4

Sample size

1

Population

Single adult patient with co-occurring persistent postural-perceptual dizziness (PPPD) and chronic anxiety

Intervention

Osteopathic cranial manipulative medicine (OCMM)