Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder defined by persistent dizziness, unsteadiness, or non-spinning vertigo exacerbated by upright posture, active or passive motion, and visually complex environments....
✦ The floor
Discussion
Signed responses from readers of the wire.
Audiologists and vestibular specialists managing PPPD patients should consider a phenotype-based approach to tailor treatment plans, though the review's specific recommendations require validation in prospective trials before broadly changing practice.
PPPD is a common but underdiagnosed chronic vestibular condition frequently encountered in audiology-adjacent vestibular clinics; a structured phenotype-based management framework could improve individualized patient care.
- 01PPPD is a chronic functional vestibular disorder causing persistent dizziness and unsteadiness without a clear structural cause.
- 02The review proposes grouping patients by symptom pattern (phenotype) to guide treatment choices.
- 03Frontiers in Neurology published this clinical management review.
- 04Treatment approaches discussed may include vestibular rehabilitation, cognitive behavioral therapy, and pharmacotherapy.
- 05Phenotype-based frameworks are not yet validated in large prospective trials.
A phenotype-oriented approach improves practical management of persistent postural-perceptual dizziness.
opinionpartially supported- PMID
- 42609267
- DOI
- 10.3389/fneur.2026.1879813.
- Journal
- Frontiers in Neurology
- Publication type
- review
- Evidence level
- 5
- Population
- Patients with persistent postural-perceptual dizziness (PPPD)
- Intervention
- Phenotype-oriented management approach for PPPD
Primary outcomes
Practical clinical management of PPPD; Symptom-based patient categorization