what is persistent postural perceptual dizziness?
Persistent Postural Perceptual Dizziness, or 3PD, is a condition in which the brain has difficulty organizing and processing sensory information. This sensory information includes your vision, vestibular system, and somatosensory system.
What Causes Persistent Postural Perceptual Dizziness?
Each of your sensory systems (visual, vestibular, and somatosensory) has to work together to provide the same information to the brain to keep you upright and balance. If there is a change or injury to one of these systems, sometimes the brain has a hard time getting back to normal and has difficulty processing the information. 3PD can also exist when those sensory systems are functioning appropriately, but the brain has experienced changes or injuries, such as in the case of vestibular migraines. Sometimes 3PD is brought on just through stress or other medical conditions.
What Does 3PD Feel Like?
3PD is often described as a swaying or rocking sensation. These symptoms are often more constant or lasting hours and will get worse in busy visual environments such as a grocery store, crowded area, or with busy visual patterns like gingham, chevron, etc. People often describe their symptoms being worse with standing and better with sitting or laying down. When you sit or lay down you have more sensory input through your body to give your brain a better sense of where you are in space, compared to just having the bottom of your feet in contact with a stable surface.
How is Persistent Postural Perceptual Dizziness Diagnosed?
3PD is typically diagnosed based off of how your symptoms are presenting. To have a diagnosis of 3PD, you need to have:
Dizziness that is non-spinning (often it is described as a rocking or swaying)
Dizziness occurs most days
Have had these symptoms for longer than 3 months
Dizziness lasts hours or longer, may get better or worse throughout the day
Symptoms are worse with standing, movement (whether you are moving or riding in a car), and busy visual environments
Symptoms came on after another medical condition, stress, or vestibular disorder
Symptoms cause distress or impact your ability to perform daily tasks
Other conditions have been ruled out
Who Treats 3PD?
Vestibular physical therapists treat 3PD! We focus on increasing the input from your vestibular system to help the brain re-organize and prioritize information better and more efficiently. This will help you feel more stable and balanced! One problem common to 3PD is a dependence on your vision for your balance. We provide exercises to help you decrease that visual dependency and help your brain trust your vestibular system again. Sometimes neuro-optometrists can provide vision therapy if there are visual deficits.
