持續姿勢─知覺性頭暈(PPPD)

Persistent Postural-Perceptual Dizziness (PPPD)

持續姿勢－知覺性頭暈（persistent postural-perceptual dizziness , PPPD）是持續存在大於3個月的非旋轉性頭暈，可因姿勢改變、或對空間移動的感受敏感而惡化。這是一個新定義的功能性疾病。病因可能來自平衡功能適應不良造成的惡性循環。發病前的誘因事件，影響了病患的平衡控制，導致肌肉繃緊、步伐變小、過度警覺並且過度仰賴視覺維持平衡。即使在誘因事件結束後，病人仍無法重新適應，因而持續頭暈。這是一種相當常見的慢性頭暈，好發於中年，女性比例較高。教育病人讓病人認識自己的診斷，同時進行認知行為治療，並以前庭復健讓病人重新統合平衡系統，最後輔以藥物，如此結合多重專業，才是最佳的治療。

Persistent postural-perceptual dizziness (PPPD) is a syndrome of persistent non-spinning dizziness for more than 3 months that is exacerbated by postural challenges and perceptual sensitivity to space-motion stimuli. PPPD is a newly defined functional disorder. It may be a result of maladaptation to balance challenges. A precipitating event alters patient’s balance control having stiffened muscles, smaller steps, hypervigilance, and shifting to a reliance on visual over vestibular information. The mechanisms persist without readaptation even the precipitant is solved to make the dizziness persist. PPPD is a common cause of chronic dizziness. Middle-aged women have the highest prevalence. Multidisciplinary therapies including cognitive behavioral therapy, vestibular rehabilitation to reconstruct balance system, and medications as well as patient education are the best ways to the treatment.