What tests are used to diagnose PPPD?
There is no single test to diagnose PPPD. At Children’s Hospital Colorado, experts at our Pediatric Mental Health Institute (PMHI) help to diagnose and treat PPPD, while our Pediatric Balance and Vestibular Disorders Clinic work together to diagnose and treat the symptoms and underlying causes.
Your child will have a comprehensive neurologic and vestibular testing to rule out other causes of dizziness. We may also recommend evaluation by an ear, nose and throat (ENT) doctor and imaging tests such as an MRI or CT scan.
If possible, we ask that you keep a journal of your child’s episodes. Details including time and length of episodes, symptoms and events that may have triggered an episode can help us make a diagnosis.
We follow diagnostic criteria formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society. The criteria to diagnose persistent postural perceptual dizziness are:
- One or more symptoms of dizziness, unsteadiness, or non-spinning vertigo are present on most days for 3 months or more.
- Symptoms last for prolonged (hours-long) periods of time but may get more or less severe.
- Symptoms need not be present continuously throughout the entire day, but often worsen throughout the day.
- Persistent symptoms occur without specific cause, but are exacerbated by three factors:
- Upright posture
- Active or passive motion without regard to direction or position
- Exposure to moving visual stimuli or complex visual patterns
- The disorder develops after conditions that cause vertigo, unsteadiness, dizziness, or problems with balance including acute, episodic, or chronic vestibular syndromes, other neurologic or medical illnesses, or psychological distress.
- When the cause is an acute or episodic condition, symptoms settle into a pattern. They may occur intermittently at first, and then become persistent.
- When the cause is a chronic syndrome, symptoms may develop slowly at first and worsen gradually.
- Symptoms cause significant distress or functional impairment.
- Symptoms are not better accounted for by another disease or disorder.
What can I expect from PPPD testing?
The first step is a vestibular evaluation, which may require a referral to Audiology Services from your child’s doctor. This evaluation varies depending on your child’s age and developmental level and will be scheduled for 1.5 - 2.5 hours.
Depending on the evaluation results, your child may be referred to the Pediatric Balance and Vestibular Disorders Clinic for a multidisciplinary exam by doctors from Otolaryngology (ENT), Audiology, Physical Therapy and Neurology. If there are concerns for PPPD or general mental health concerns, your child may also be referred to the Pediatric Mental Health Institute (PMHI).