Table 1. Bárány Society diagnostic criteria for persistent postural-perceptual dizziness

A. One or more symptoms of dizziness, unsteadiness or non-spinning vertigo on most days for at least 3 months.

1. Symptoms last for prolonged (hours-long) periods of time, but may wax and wane in severity.

2. Symptoms need not be present continuously throughout the entire day.

B. Persistent symptoms occur without specific provocation, but are exacerbated by three factors : upright posture, active or passive motion without regard to direction or position, and exposure to moving visual stimuli or complex visual patterns.

C. The disorder is triggered by events that cause vertigo, unsteadiness, dizziness, or problems with balance, including acute, episodic or chronic vestibular syndromes, other neurological or medical illnesses, and psychological distress.

1. When triggered by an acute or episodic precipitant, symptoms settle into the pattern of criterion A as the precipitant resolves, but may occur intermittently at first, and then consolidate into a persistent course.

2. When triggered by a chronic precipitant, symptoms may develop slowly at first and worsen gradually.

D. Symptoms cause significant distress or functional impairment.

E. Symptoms are not better accounted for by another disease or disorder.