Persistent Postural‐Perceptual Dizziness: A Practical Approach to Diagnosis and Patient Communication

BACKGROUND: Despite clear diagnostic criteria established in 2017, delivering and explaining the diagnosis of persistent postural-perceptual dizziness (PPPD) can be challenging. METHODS: We outline a step-by-step approach to clearly explain the diagnosis, underlying mechanisms and treatment options to patients with PPPD, followed by a brief overview of current treatment approaches. This approach is adapted from the Cambridge-Calgary Consultation Model and previous recommendations for functional neurological disorders but is mainly based on our expertise accrued over decades and input from patients with PPPD. RESULTS: The practical clinical framework for the assessment and management of PPPD includes structured history-taking, bedside examination and patient-centred communication strategies aimed at improving diagnostic confidence and therapeutic engagement. CONCLUSION: Our experience indicates that the clinical approach used may shape patients' understanding, engagement and overall management trajectory in PPPD. Good communication is essential for the diagnosis and management of this condition.