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  • Writer's pictureEngage PT, OT, SLP Therapy and Wellness

What is Persistent postural-perceptual dizziness (PPPD or 3PD)?

Updated: May 6, 2023

Persistent postural-perceptual dizziness (PPPD, pronounced three PD) is a common cause of chronic, long-lasting dizziness. PPPD is a condition usually felt as a lasting sensation of rocking, swaying, mental fogginess, floating or light-headedness. PPPD usually begins after a triggering event such as an episode of vertigo, migraine or concussion. Symptoms usually get worse when standing or sitting upright, moving the head or body, or when looking at busy visual patterns or moving environments. Symptoms are usually better when lying down.

A doctor diagnoses PPPD based on a person’s medical history and the description and duration of their symptoms. PPPD may be diagnosed if symptoms last 3 months or more, with symptoms present on most days (at least 15 out of every 30 days). PPPD is one of the most common causes of chronic dizziness for people 30-50 years old.

PPPD can be very frustrating for people who have it. People with PPPD often become anxious about experiencing an increase in symptoms, losing their balance or falling. They may avoid situations that make their symptoms worse, to the point where it can start to interfere with their self care, work, school and leisure time. Many health care professionals are not very familiar with dizziness, and the symptoms of PPPD can be vague and hard to describe, so it may not be diagnosed for some time. Once PPPD is identified as the problem, a multifaceted treatment approach is usually recommended including: physical and occupational therapy, counseling, and medication.



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