Exacerbating Factors in Persistent Postural-perceptual Dizziness
Researchers have found that found that patients developing persistent postural-perceptual dizziness (PPPD) are likely to have exacerbating factors soon after the onset of balance disorder symptoms. The results were reported in Laryngoscope Investigative Otolaryngology.
When people experience vestibular symptoms, it can develop into persistent postural-perceptual dizziness (PPPD), a chronic disorder where patients experience dizziness and non-spinning vertigo, particularly during moving, maintaining an upright posture, and when exposed to complex visual stimuli. However, not all individuals suffering from vestibular symptoms go on to develop PPPD, and it unclear whether people showing exacerbating factors for PPPD tend to develop PPPD or not.
Assistant Professor Kayoko Kabaya led a team that analysed medical records of patients who were tested for vestibular symptoms for the first time to identify predictive factors for developing PPPD later on, and to see if the presence of exacerbating factors early on increases the likelihood of developing chronic PPPD. “PPPD is often severe and resistant to treatment. We believe that it is important to provide preventive interventions before PPPD develops, and wanted to identify the characteristics of patients who are prone to PPPD,” explained Dr Kabaya.
In their study, the severity of the symptoms experienced by the patients was scored with a questionnaire which involved questions on the exacerbating factors. Additionally, the perceived handicap due to dizziness was evaluated using a self-assessment scale. There was three months of follow-up, and the symptom scores of patients developing PPPD during the follow-up were compared with that of patients who did not develop PPPD.
More than half of the patients reported experiencing exacerbating factors shortly after the vestibular symptoms. About 10% of these patients developed PPPD during the follow-up period, and the exacerbating factors were found to have a more severe effect on the vestibular symptoms. Notably, the symptom scores of those who developed PPPD were significantly higher than that of those who did not.
“Our results suggest that patients who develop PPPD are likely to have its exacerbating factors at the early stages of the disease following the onset of vestibular symptoms,” said Dr Kabaya.
The researchers believe the results could lead to preventive measures against the disease. “PPPD is a disease that causes long-term social loss and occurs following acute vestibular symptoms. Based on our finding that patients with exacerbating factors during acute vestibular symptom are more likely to develop PPPD, our study could encourage the development of intervention protocols for such patients before they develop PPPD,” said Dr Kabaya.
Source: Nagoya City University