Mal de Débarquement Syndrome (MdDS)

Mal de débarquement syndrome, commonly referred to as MdDS, is a rare condition marked by a feeling of self-motion and imbalance. Self-motion is the subjective sense that one is moving, despite standing, sitting or lying in an objectively still position. Most often, MdDS patients describe this perceived self-motion as rocking or swaying.

The French phrase “Mal de débarquement” translates to “sickness of disembarkment,” and–as the name suggests–the syndrome typically materializes after disembarking from a moving vehicle. It is experienced most often by those who have traveled by boat, but occasionally occurs after a journey by a plane, train or automobile.

While MdDS typically resolves itself within a few days, it occasionally persists long beyond that point. Because it is so rare–and because MdDS symptoms may be similar to other disorders–anyone experiencing self-motion for longer than a few days should visit an ear, nose and throat (ENT) doctor. The team at Sierra Nevada ENT specializes in properly diagnosing and treating conditions such as Mal de débarquement syndrome.

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What Causes Mal de Débarquement Syndrome?

When individuals are exposed to repetitive, passive motion–such as the rocking or swaying of a cruise ship–for an extended period of time, they may feel unsteady or experience periods of imbalance when returning to land. This is not uncommon, and it typically resolves itself within 24 to 72 hours of disembarkment.

Occasionally, however, this phantom sense of self-motion can last for months or even years. There is evidence that females between the ages of 40 and 60 are at the greatest risk for developing persistent Mal de débarquement. Researchers are still trying to determine why that may be and identify the underlying cause(s).

Most researchers do agree that MdDS is a vestibular disorder. “Vestibular” refers to the intricate network between the inner ear and brain that processes sensory cues and controls balance. As you move, so does the fluid in your ear, sending messages to your brain about spatial positioning. When this process is disrupted, balance problems–vestibular disorders–can occur.

Prolonged MdDS symptoms can negatively impact daily functions, and individuals suffering from this disorder may experience confusion, fatigue, anxiety or depression, in addition to other issues.

What are the Symptoms?

Phantom motion is the most common symptom of Mal de débarquement syndrome. This is typically described as a feeling of rocking, swaying or bobbing. These feelings often lead to imbalance issues or result in an unsteady gait. MdDS may resolve spontaneously or persist over a long period of time. 

Symptoms of MdDS tend to:

  • Occur after exposure to repetitive motion
  • Improve when moving–e.g. returning to a boat, driving a car or walking
  • Worsen when sitting or lying still
  • Worsen when under stress

MdDS symptoms typically do NOT include:

  • Vertigo
  • Nausea
  • Hearing loss

However, symptoms such as vertigo and hearing loss are often associated with other vestibular disorders, so if a patient is experiencing any of these in conjunction with phantom motion or imbalance, it is still important to visit a qualified ear, nose and throat (ENT) doctor.

The experts at Sierra Nevada ENT specialize in vestibular disorders. They can provide a proper diagnosis, which is crucial to understanding the cause of your symptoms and determining an appropriate MdDS treatment plan.

Treating MdDS

If you experience any of the symptoms listed above for more than a few days, visit an ENT for professional diagnosis and treatment.

If a patient is diagnosed with MdDS, treatment options may include medication, physical therapy or a combination of the two.

Some patients find that a prescription for motion sickness medication or antidepressants helps alleviate or manage symptoms. Balance therapy–also referred to as vestibular rehabilitation therapy–has also proven highly effective in reducing and even eliminating the symptoms of vestibular disorders, including vertigo, dizziness, gaze instability, imbalance and/or falls, as well as accompanying symptoms such as headaches, nausea, fatigue and disorientation.

Balance therapy helps to decrease the severity of symptoms through consistent exposure to problematic stimuli and movements that build upon one another gradually in a safe and professional setting.

The therapists at Sierra Nevada ENT’s Center for Vestibular Rehabilitation will customize a MdDS treatment plan, working with the individual in a one-on-one setting, as well as providing an exercise routine that can be performed at home. Our goal is to help patients identify, manage and reduce MdDS symptoms in order to return to normal daily function.

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