In 2006, members of the Bárány Society created a working group to standardize nomenclature for vestibular diseases and disorders worldwide. This led to formation of the Committee for Classification Vestibular Disorders of the Bárány Society (CCBS) to oversee development of the first International Classification of Vestibular Disorders (ICVD) [8 (link)]. To date, this process has generated consensus documents defining vestibular symptoms [9 (link)], vestibular migraine [49 (link)], Menière’s disease [51 (link)], BPPV [87 (link)], and vestibular paroxysmia [82 (link)]. Additional definitions are in the offing. In 2010, the CCBS chartered a Behavioral Subcommittee to identify primary and secondary psychiatric disorders that cause or amplify vestibular morbidity and review evidence about the nature of PPV, SMD, VV, and CSD. In keeping with established procedures for the classification process [5 ], the Behavioral Subcommittee included an otologist (A.H.), neurologist (M.S.), and members with special expertise in psychosomatic medicine (J.P.S., A.E.H.) and psychiatry (J.P.S., R.J.). Members hailed from three continents (Asia, Europe, and North America). Two senior neuro-otologists (T.B., A.B.) graciously agreed to advise subcommittee members on their deliberations.
The subcommittee met for the first time in August 2010 during the Bárány Society’s biennial congress in Reykjavík, Iceland. From 2010–2012, the chair (J.P.S.) consulted with subcommittee members individually. These deliberations produced a consensus that PPV, SMD, VV, and CSD included a core set of physical symptoms that represented a distinctly definable vestibular disorder. Subcommittee members prepared a draft definition of this disorder that was updated iteratively after review by the general membership of the Bárány Society in June 2012 in Uppsala, Sweden, the CCBS in November 2013 in Mondorf-les-Bains, Luxembourg, and then again by the general membership in May 2014 in Buenos Aires, Argentina. Additional feedback was solicited from scientific societies dedicated to otorhinolaryngology, neurology, psychiatry, and psychosomatic medicine worldwide and from individual members of the Bárány Society via a posting of the draft definition to the ICVD development webpage of the Journal of Vestibular Research. The subcommittee used this feedback to prepare the final definition, which was approved by the CCBS.
The disorder was named persistent postural-perceptual dizziness to reflect its main diagnostic criteria of persistent non-vertiginous dizziness, unsteadiness, and non-spinning vertigo that are exacerbated by postural challenges and perceptual sensitivity to space-motion stimuli. A separate, 100-word narrative definition was prepared for the World Health Organization as part of the Bárány Society’s recommendations for updates to the vestibular disorders section of the forthcoming 11th edition of the International Classification of Diseases (ICD-11) [97 ].
The subcommittee met for the first time in August 2010 during the Bárány Society’s biennial congress in Reykjavík, Iceland. From 2010–2012, the chair (J.P.S.) consulted with subcommittee members individually. These deliberations produced a consensus that PPV, SMD, VV, and CSD included a core set of physical symptoms that represented a distinctly definable vestibular disorder. Subcommittee members prepared a draft definition of this disorder that was updated iteratively after review by the general membership of the Bárány Society in June 2012 in Uppsala, Sweden, the CCBS in November 2013 in Mondorf-les-Bains, Luxembourg, and then again by the general membership in May 2014 in Buenos Aires, Argentina. Additional feedback was solicited from scientific societies dedicated to otorhinolaryngology, neurology, psychiatry, and psychosomatic medicine worldwide and from individual members of the Bárány Society via a posting of the draft definition to the ICVD development webpage of the Journal of Vestibular Research. The subcommittee used this feedback to prepare the final definition, which was approved by the CCBS.
The disorder was named persistent postural-perceptual dizziness to reflect its main diagnostic criteria of persistent non-vertiginous dizziness, unsteadiness, and non-spinning vertigo that are exacerbated by postural challenges and perceptual sensitivity to space-motion stimuli. A separate, 100-word narrative definition was prepared for the World Health Organization as part of the Bárány Society’s recommendations for updates to the vestibular disorders section of the forthcoming 11th edition of the International Classification of Diseases (ICD-11) [97 ].