Popkirov Stoyan, Staab Jeffrey P, Stone Jon
Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr-University Bochum, Bochum, Germany.
Department of Psychiatry and Psychology and Otorhinolaryngology - Head and Neck Surgery, Mayo Clinic Minnesota, Rochester, Minnesota, USA.
Pract Neurol. 2018 Feb;18(1):5-13. doi: 10.1136/practneurol-2017-001809. Epub 2017 Dec 5.
Persistent postural-perceptual dizziness (PPPD) is a newly defined diagnostic syndrome that unifies key features of chronic subjective dizziness, phobic postural vertigo and related disorders. It describes a common chronic dysfunction of the vestibular system and brain that produces persistent dizziness, non-spinning vertigo and/or unsteadiness. The disorder constitutes a long-term maladaptation to a neuro-otological, medical or psychological event that triggered vestibular symptoms, and is usefully considered within the spectrum of other functional neurological disorders. While diagnostic tests and conventional imaging usually remain negative, patients with PPPD present in a characteristic way that maps on to positive diagnostic criteria. Patients often develop secondary functional gait disorder, anxiety, avoidance behaviour and severe disability. Once recognised, PPPD can be managed with effective communication and tailored treatment strategies, including specialised physical therapy (vestibular rehabilitation), serotonergic medications and cognitive-behavioural therapy.
持续性姿势 - 知觉性头晕（PPPD）是一种新定义的诊断综合征，它整合了慢性主观性头晕、恐惧性姿势性眩晕及相关障碍的关键特征。它描述了前庭系统和大脑的一种常见慢性功能障碍，会产生持续性头晕、非旋转性眩晕和/或不稳感。该病症是对引发前庭症状的神经耳科、医学或心理事件的一种长期适应不良，并且在其他功能性神经障碍范围内进行考量是很有意义的。虽然诊断测试和传统影像学检查通常结果为阴性，但PPPD患者呈现出符合阳性诊断标准的特征性表现。患者常出现继发性功能性步态障碍、焦虑、回避行为及严重残疾。一旦确诊，PPPD可通过有效的沟通和量身定制的治疗策略进行管理，包括专业物理治疗（前庭康复）、血清素能药物及认知行为疗法。
