Persistent Postural-Perceptual Dizziness in Older Adults - Neurology

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Persistent Postural-Perceptual Dizziness (PPPD) is a condition that can significantly affect the quality of life, particularly in older adults. It is characterized by a persistent sensation of dizziness or unsteadiness that is often triggered by changes in posture or movement. This condition can be particularly distressing, as it may lead to a fear of falling, which can further limit mobility and independence.

In your mother's case, her symptoms of feeling like the surroundings are shaking and experiencing dizziness upon movement are indicative of PPPD. This condition often arises after an initial vestibular event, such as a viral infection, inner ear disorder, or even anxiety. The brain may become hypersensitive to movement and changes in posture, leading to a persistent sensation of dizziness even when there is no actual disturbance.

Given that your mother has been experiencing these symptoms for several months, it is crucial to seek medical attention. A visit to a neurologist or an ear, nose, and throat (ENT) specialist would be appropriate. These specialists can perform a thorough evaluation, which may include a detailed medical history, physical examination, and possibly imaging studies or vestibular testing to rule out other causes of her symptoms.

In terms of immediate management, there are several strategies that may help alleviate her symptoms:
1. Vestibular Rehabilitation Therapy (VRT): This is a specialized form of physical therapy designed to help patients with balance disorders. VRT can help retrain the brain to process balance information more effectively and reduce dizziness.

2. Medication: Depending on the underlying cause and severity of symptoms, medications such as vestibular suppressants (e.g., meclizine) or anti-anxiety medications may be prescribed to help manage symptoms.

3. Lifestyle Modifications: Encourage your mother to avoid sudden movements and to rise slowly from sitting or lying positions. Staying hydrated and avoiding caffeine and alcohol can also be beneficial.

4. Cognitive Behavioral Therapy (CBT): If anxiety is a significant component of her dizziness, CBT may help her manage the psychological aspects of her condition.

5. Education and Support: Understanding the condition can help reduce anxiety. Providing reassurance and support from family members can also be beneficial.

It is essential to monitor her symptoms closely and keep a record of any changes or triggers. If her condition worsens or if she experiences additional symptoms such as severe headache, vision changes, or weakness, it is crucial to seek emergency medical care.

In summary, your mother's symptoms are concerning and warrant a thorough medical evaluation. A neurologist or ENT specialist can provide a comprehensive assessment and develop a tailored treatment plan. In the meantime, implementing some of the management strategies mentioned above may help improve her comfort and quality of life.