Neurological disorders and injuries

Persistent Postural-Perceptual Dizziness

A chronic feeling of unsteadiness or dizziness, often triggered by being upright or in busy environments.
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About

Persistent Postural-Perceptual Dizziness (PPPD) is a chronic condition that causes a person to feel unsteady or dizzy, particularly when upright, moving, or exposed to complex environments like crowded or visually busy spaces. It often follows a vestibular disorder, concussion, or period of high stress or anxiety.

This condition is often invisible.

Many disabilities, including this one, may not have outward signs—people can be significantly impacted even if they appear “fine” on the outside.

Common Challenges

  • Feeling off-balance or lightheaded when standing or walking
  • Difficulty working in visually stimulating or noisy environments
  • Fatigue and concentration issues related to dizziness
  • Anxiety or distress triggered by symptom flare-ups
  • Trouble with commuting or moving around the workplace
  • Sensitivity to bright lights, screens, or motion

Practitioner Help

  • Help manage symptoms with vestibular rehabilitation or balance exercises
  • Support stress and anxiety reduction techniques
  • Identify workplace triggers and recommend adjustments
  • Assist with gradual return-to-work planning
  • Provide psychoeducation and communication tools

Common Accommodations

  • Allowing breaks to rest or recalibrate balance
  • Avoiding tasks that require quick head movements or complex visual input
  • Flexible work hours or part-time schedules
  • Adjustments to lighting and contrast on computer screens
  • A quiet or low-sensory workspace
  • Flexible working hours or part-time work
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Notes

PPPD can fluctuate day to day and may be affected by both physical and emotional factors. With the right support, individuals can remain active in the workforce and manage their symptoms effectively.

Resources

  • Persistent Postural-Perceptual Dizziness - Vestibular Disorders Association
  • Functional Dizziness (PPPD) – Functional Neurological Disorder (FND)
  • Dizziness - symptoms, treatments and causes | healthdirect
  • Persistent Postural-Perceptual Dizziness - StatPearls - NCBI Bookshelf
Neurological disorders and injuries

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