A Study of Predisposing Factors of Persistent Postural Perceptual Dizziness (PPPD) in Eastern Indian Population
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Abstract
Objective: To study patients with PPPD during the study period and to identify the predisposing factors giving rise to this condition
Methodology: Patients attending the Neurology outpatient department at Aarogyam Neuroclinic, Durgapur, West Bengal from January 2021 to October 15, 2021 fulfilling the Modified Barany society criteria for PPPD were included in the study. All these patients were examined in detail and all necessary investigations were done to rule out other differential diagnosis.
Results: Total of 60 patients satisfied the diagnostic criteria of PPPD during the study period .Out of 60 patients, 40 (66.67%) were male and 20(33.33%) were female. Most common Age groups were 40-49 years(31.66%),30-39 years(25%) and 60-69(18.33%).A study of the risk factors showed Anxiety disorders(43.33%), Migraine(31.66%), Combination of Migraine and Anxiety disorder(23.33%), Pheripheral vertigo related conditions(23.33%), Insomnia(16.66%), Fibromyalgia(10%) and depression(10%). In pheripheral vertigo related disorders- 8 had benign positional postural vertigo,2 had vestibular neuritis, 1 had meniers disease and 2 unclassified disorder. 24(40%) patients had degenerative cervical or Lumbar pain related to degenerative spine diseases.
Conclusion: It is a common disorder seen in the age group 30-50 years. Most common predisposing causes are Anxiety disorder ,Migraine, combination of both and peripheral vertigo related disorders. Many of the patients have associated pain disorders like fibromyalgia and spine diseases.
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References
I. Strupp M, Glaser M, Karch C, Rettinger N, Dieterich M, Brandt T. The most common form of dizziness in middle age: phobic postural vertigo. Der Nervenarzt 2003;74: 911–914.
II. Dieterich M, Staab J, Brandt T. Functional (Psychogenic) Dizziness. In: Handbook of Clinical Neurology. Philadelphia: Elsevier; 2016:447–468.
III. Staab JP, Eckhardt-Henn A, Horii A, et al. Diagnostic criteria for persistent postural perceptual dizziness (PPPD): consensus document of the Committee for the Clas sification of Vestibular Disorders of the B´ar´any Society. J Vestib Res 2017;27: 191–208.
IV. Dieterich M, Staab JP. Functional dizziness: from phobic postural vertigo and chronic subjective dizziness to persistent postural-perceptual dizziness. Curr Opin Neurol 2017;30:107–113.
V. Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): consensus document of the committee for the classification of vestibular disorders of the Barany Society. J Vest Res. (2017)
VI. 6:191– 208. doi: 10.3233/VES-170622 2. Staab JP. Persistent postural-perceptual dizziness. Semin Neurol. (2020) 40:130–7. doi: 10.1055/s-0039-3402736
VII. Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res. (2017) 27:191– 208. doi: 10.3233/VES-170622
VIII. World Health Organization. International Classification of Diseases, 11th Edition Beta Version Draft (ICD-11 Beta), Definition of Persistent Postural Perceptual Dizziness. Available online at: https://icd.who.int/dev11/l-m/en#/ http%3a%2f%2fid.who.int%2ficd%2fentity%2f2005792829
IX. Trinidade A, Goebel JA. Persistent postural-perceptual dizziness (PPPD) – a systematic review of the literature for the balance specialist. Otol Neurotol. (2018) 39:1291–303.
doi: 10.1097/MAO.000000000 0002010 4.
X. .Godemann F, Siefert K, Hantschke-Brüggemann M, Neu P, Seidl R, Ströhle A. What accounts for vertigo one year after neuritis vestibularis - anxiety or a dysfunctional vestibular organ? J Psychiatr Res. (2005) 39:529–34.
doi: 10.1016/j.jpsychires.2004.
XI. .006 5. Heinrichs N, Edler C, Eskens S, Mielczarek MM, Moschner C. Predicting continued dizziness after an acute peripheral vestibular disorder. Psychosom Med. (2007) 69:700–7.
doi: 12.1097/PSY.0b013e3181 51a4dd
XII. Cousins S, Kaski D, Cutfield N, Arshad Q, Ahmad H, Gresty MA, et al. Predictors of clinical recovery from vestibular neuritis: a prospective study. Ann Clin Transl Neurol. (2017) 4:340–6. doi: 10.1002/ acn3.386
XIII. . Best C, Tschan R, Eckhardt-Henn A, Dieterich M. Who is at risk for ongoing dizziness and psychological strain after a vestibular disorder? Neuroscience. (2009) 164:1579–87. doi: 10.1016/j.neuroscience.2009. 09.034
XIV. Staab JP. Persistent postural-perceptual dizziness. Semin Neurol. (2020) 40:130–7. doi: 10.1055/s-0039-3402736
XV. A. Bisdorff, M. von Brevern, T. Lempert and D.E. Newman-Toker, Classification of vestibular symptoms: Towards an international classification of vestibular dis orders, J Vestib Res 19 (2009), 1–13.
XVI. T. Brandt and M. Dieterich, Phobischer Attacken Schwankschwindel, ein neues Syndrom? Munch Med Wschr 28 (1986), 247–250
XVII. J.P. Staab, Chronic subjective dizziness, Continuum: Life long Learning in Neurology (Minneap Minn) 18 (2012), 1118–1141
XVIII. T. Brandt and M. Dieterich, Phobischer Attacken Schwankschwindel, ein neues Syndrom? Munch Med Wschr 28 (1986), 247–250
XIX. [19] J.P. Staab and M.J. Ruckenstein, Expanding the differential diagnosis of dizziness, Arch Otolaryngol Head Neck Surg 133 (2007), 170–176.
XX. R.S.M. Bittar and E.M.D. von Sohsten Lins, Clinical ¨ characteristics of patients with persistent postural perceptual dizziness, Braz J Otorhinolaryngology 81 (2015), 276–282
XXI. Yan, L. Cui, T. Yu, H. Liang, Y. Wang and C. Chen C, Analysis of the characteristics of persistent postural perceptual dizziness: A clinical-based study in China, Int J Audiol 56 (2016), 1–5.