Prevalence and Severity of Persistent Postural-Perceptual Dizziness in Patients with Peripheral Vestibular Disorders: A Cross-Sectional Study

Objective: Persistent Postural-Perceptual Dizziness (PPPD) is a chronic functional disorder of the nervous system that is characterized by non-spinning vertigo and perceived unsteadiness. PPPD can occur along with other Peripheral Vestibular Disorders (PVD) and can complicate the condition, but the prevalence and severity of the comorbidity have not been reported. This study aimed to investigate the prevalence and severity of PPPD in patients with PVD. Materials and methods: A cross-sectional study was conducted at the department of neuro-otology in secondary and tertiary settings. Outpatients with PVD were selected through continuous sampling. All participants were diagnosed by neuro-otologists and completed three questionnaires: the Dizziness Handicap Inventory (DHI), Vertigo Symptom ScaleShort Form (VSS-SF), and Hospital Anxiety and Depression Scale (HADS). Results: Among 187 consecutive patients, 173 patients (92.5%) with PVD were analyzed. Sixty-nine patients (39.9%, (32.5-42.6, and 95% confidence interval)) developed PPPD as a comorbidity. All patients with PPPD had dizziness symptoms that were unrelated to vestibular dysfunction. With regard to the total DHI score, the patients with PPPD (36 (26-54), median (interquartile range)) showed significantly higher scores than those without PPPD (28 (10-47)) (p=0.006). With regard to the Vestibular Symptoms Scores in VSS-SF, patients with PPPD showed significantly higher scores than those without PPPD. Conclusion: In the secondary and tertiary settings, 4 out of 10 patients with PVD may have PPPD as comorbidity and have a more severe condition. Patients with PVD who have persistent dizziness or unsteadiness should be positively considered for PPPD.