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PPPD Diagnostic Inventory

All eight original entries are preserved below with their original wording and source associations. These are criteria, investigation groups and questionnaires, not eight independently validated diagnostic tests. No new diagnostic entry is added.

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Detailed guides

Original eight entries

Criterion A: persistent dizziness pattern

The history establishes dizziness, unsteadiness or non-spinning vertigo on most days for at least three months. Symptoms typically last hours and may fluctuate. This is a required part of Bárány consensus criteria, not a standalone test. [1]

Criterion B: three exacerbating factors

Symptoms are worsened by upright posture, active or passive movement, and moving or visually complex surroundings. The clinician establishes all three domains from history; deliberate symptom provocation is unnecessary. Other vestibular conditions can share individual features. [1]

Criterion C: precipitating condition

The clinician establishes onset following a condition producing dizziness, imbalance or distress, such as an acute or chronic vestibular disorder. The course may consolidate as the precipitant changes. This requirement does not mean a psychological trigger must be present. [1]

Criterion D: meaningful impact

Symptoms must cause significant distress or functional impairment. The assessment records effects on daily life rather than requiring a particular severity score. Disability establishes impact, not the cause by itself. [1]

Criterion E: no better explanation

The full pattern must not be better accounted for by another disorder. Other conditions may coexist with PPPD. This differential requirement sits alongside positive symptom criteria; normal tests alone do not establish the syndrome. [1]

Vestibular and positional examinations

Head-impulse, nystagmus, positional and other indicated vestibular assessments investigate coexisting or alternative causes. There is no pathognomonic examination or laboratory test for PPPD. An abnormal vestibular test does not automatically exclude it. [1]

Orthostatic and neurological assessment

Where indicated, standing blood pressure, heart rate and neurological examination help distinguish cardiovascular or neurological causes of dizziness. These are differential investigations, not positive PPPD tests. [1]

Symptom questionnaires

Scales can characterize exacerbating situations and severity. The Niigata PPPD Questionnaire has validation research, but a questionnaire score supplements rather than replaces the full consensus criteria and differential assessment. [1][2]

Research and Sources

Original local citation numbers are retained. Later questionnaire evidence is discussed in the measurement guide.

Citation	Figure	Full citation
[1]	—	Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, Bronstein A. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): consensus document of the Committee for the Classification of Vestibular Disorders of the Bárány Society. Journal of Vestibular Research. 2017;27(4):191–208. FND-CIT-0027. https://doi.org/10.3233/VES-170622
[2]	—	Yagi C, Morita Y, Kitazawa M, et al. A Validated Questionnaire to Assess the Severity of Persistent Postural-Perceptual Dizziness (PPPD): The Niigata PPPD Questionnaire (NPQ). Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 2019;40(7):e747-e752. DOI. PMID: 31219964. FND-CIT-0156.

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