Prevalence and treatment outcomes of persistent postural-perceptual dizziness after traumatic brain injury

Abstract

Background: Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder that is a potential sequela of traumatic brain injury (TBI). Currently, little is known about how patients with TBI associated PPPD respond to typical PPPD treatment modalities. Objective: To investigate the prevalence of TBI as a precipitant for PPPD and assess outcomes of usual treatment. Design: Retrospective cohort study. Setting: Electronic medical records from a tertiary care center. Participants: Patients ≥18 years of age diagnosed with PPPD secondary to TBI between January 2015 and December 2022 who underwent 6 months of treatment with at least one return clinic visit. Interventions: Not applicable. Main Outcome Measure(s): Patients' best clinical global impression-improvement scale (CGI-I) score following 6 months of treatment were collected and then compared with previously published literature, with CGI-I scores of 1or 2 (indicating the patient was “very much” or “much” improved, respectively) considered treatment responders. Results: In total, 134 (8.9%) of 1503 patients had a TBI as the triggering event for PPPD. The mean age of this cohort was 47.6 years with most of these cases occurring after a mild TBI (85.8%). The proportion of females with post-TBI PPPD (58.2%) was significantly lower than the proportion with PPPD due to all causes (p