Mal de Debarquement Syndrome

Introduction

Mal de Débarquement Syndrome (MdDS), which translates to "sickness of disembarkation," is a rare and often misunderstood neurological condition.

It is characterized by a persistent phantom perception of self-motion, typically described as rocking, bobbing, or swaying.
Essentially, the brain continues to feel as though it is in motion even after the person has returned to stable ground.
While these sensations are common immediately following an ocean cruise, a long flight or a cross-country road trip, MdDS occurs when the symptoms fail to resolve.
Current research suggests that MdDS results from the central nervous system’s inability to "re-adapt" to a stable environment after being habituated to rhythmic motion.

The primary symptom of MdDS is a constant feeling of being "at sea".

Common experiences include:

Unlike other vestibular disorders (such as vertigo or Ménière’s disease), MdDS typically does not cause spinning, vomiting, tinnitus or hearing loss.

For most people, symptoms diminish within hours, but can linger for months or even years in some instances.

Symptoms lasting up to two weeks are generally considered within the normal range of physiological adaptation.

There is little effectiveness of most treatments.

Standard motion sickness medications (e.g. meclizine, dimenhydrinate, prochlorperazine, promethazine) are generally ineffective for MdDS.

Because these drugs are vestibular suppressants, their sedative effects can actually delay recovery by slowing the brain's ability to recalibrate.
However, they may be trialled in the short term to reduce the intensity of acute symptoms for some patients.

Benzodiazepines (e.g. clonazepam) are sometimes used to manage symptoms and associated anxiety.
Maintaining adequate hydration and electrolyte balance is recommended.
Vestibular rehabilitation (e.g. balance retraining and eye movement control) has shown effectiveness in a small number of patients.