Presence of exacerbating factors of persistent perceptual‐postural dizziness in patients with vestibular symptoms at initial presentation

OBJECTIVE: To investigate the presence of exacerbating factors of persistent perceptual‐postural dizziness (PPPD) in patients with vestibular symptoms during the early period after vestibular symptoms onset, and to examine possible predictive factors for developing PPPD later. METHODS: One hundred and fifty‐five consecutive patients with vestibular symptoms who presented less than 90 days from the onset were included in this study. They filled out the Niigata PPPD Questionnaire (NPQ) that consists of 12 questions on the exacerbating factors of PPPD. The NPQ scores of patients who developed PPPD were compared with those of patients who did not develop PPPD during the follow‐up. RESULTS: Seventy‐eight of the155 patients (50.3%) showed positive NPQ scores (≥27 points). High NPQ scores were found in patients diagnosed with psychogenic dizziness and vestibular neuritis. During the follow up for an average of 543.3 days after the initial presentation, eight patients (10.3%) developed PPPD. Seven of these eight patients (87.6%) showed positive NPQ scores and all of them had all three exacerbating factors of PPPD at their initial presentation. The NPQ scores of the patients who developed PPPD (40.6 ± 11.6) were significantly higher than those of the patients who did not develop PPPD (26.4 ± 18.3; p <.05). CONCLUSION: Approximately a half of the patients with vestibular symptoms had exacerbating factors of PPPD in the early stages of the disease. Patients who develop PPPD are likely to have its exacerbating factors in the initial stages after presentation. Level of Evidence: 3.