Persistent postural-perceptual dizziness (PPPD): the most common cause of chronic dizziness

Persistent postural- perceptual dizziness (PPPD) is a functional disorder that is the most frequent cause of chronic dizziness. Diagnostic criteria for PPPD were published by Bárány Society in 2017 and were then included in the International Classification of Diseases, 11th revision (ICD-11). Core symptoms are dizziness, unsteadiness or non-spinning vertigo, lasting more than three months....

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Audiologists and vestibular clinicians should be familiar with Bárány Society diagnostic criteria for PPPD, as it is the most prevalent chronic dizziness diagnosis and requires functional—not structural—management approaches distinct from peripheral vestibular disorders.

PPPD's designation as the leading cause of chronic dizziness underscores the need for vestibular clinicians to competently identify and triage this functional disorder rather than defaulting to peripheral or structural diagnoses.

1. 01PPPD is identified as the most common cause of chronic dizziness in the reviewed literature.
2. 02It is classified as a functional vestibular disorder—meaning no structural lesion is found.
3. 03Diagnosis follows formal Bárány Society criteria, ensuring standardized identification.
4. 04Management differs substantially from structural vestibular disorders, emphasizing rehab and behavioral approaches.
5. 05Review may support clinician education on distinguishing PPPD from organic vestibular pathology.

PMID

42776447

DOI

10.1007/s11604-026-02082-7.

Journal

Japanese Journal of Radiology

Publication type

review

Evidence level

5

Population

Patients with chronic dizziness, specifically those with PPPD

Intervention

Review of PPPD diagnostic criteria and clinical features