Still feel like you’re on that winter cruise you took?

A cruise that keeps going for months! Sounds great doesn’t it? Not if you have Mal de Debarquement Syndrome.

Have you ever gone out on a boat for a long period of time and when you got back onto dry land, it felt like things were still rocking?  This is a normal experience, as our vestibular system (the organs for sensing balance and movement in the inner ears and their connections in the brain) adapts to the passive motion of the boat as the ‘new normal’ and then takes a short period of time to reset back to dry land.  

However, in some people, this sensation can persist for over a month to even years after travel (on boats, but also more rarely air or land), and this is considered abnormal, and is called Mal de Debarquement Syndrome (MdDS).

MdDS is a rare condition where the underlying cause is not well-understood, and research is limited in both quantity and quality. Standard MRI scans and inner ear function tests will read normal. It was in 2012 (when a small study using more advanced neuroimaging) found altered metabolism and connectivity in certain parts of the brain of MdDS sufferers.  

MdDS tends to affect middle-aged people, is more common in females than males, and may have an association with headache, migraine, motion sickness and visual sensitivity. The most common symptoms are a sense of rocking, swaying or bobbing, and sufferers are typically more aware of the symptoms when stationary and find some relief when in motion.

According to a systematic review published in the Journal of Neurology in 2016, Mal de Debarquement Syndrome can lead to decreased quality of life, higher anxiety and depression, and even a significant socio-economic impact, likely in part due to how long it can take to get an accurate diagnosis. 

The review proposes the following criteria to help health professionals diagnosis MdDS:

1. Chronic perception of rocking dizziness (e.g., rocking, bobbing, swaying) that started after passive motion such as sea, air and land travel, or exposure to virtual reality
2. Symptoms lasting at least one month
3. Normal inner ear function or non-related abnormalities as seen by ENG/VNG and audiological [inner ear function] tests
4. Normal structural brain imaging or non-specific alterations with a non-contrast MRI scan (when no more advanced analyses were performed)
5. Symptoms not better explained by a different diagnosis (made by a physician)

Unfortunately, because there is so little understanding and research around this condition, treatment options are limited as well. A few recent studies showed some promise with treatment using magnetic stimulation of the brain, or using a technique to modulate a reflex that exists between our inner ears and eye muscles.  

MdDS does typically go away on its own within a year, however for those who are still symptomatic after a year, a spontaneous resolution is less likely. It may also be wise to avoid the type of travel that precipitated the condition in the first place to potentially prevent a recurrence.  

According to the research, the following may also be beneficial:

• Certain medications
• Stress reduction therapy
• Vestibular rehabilitation 

Vestibular rehabilitation is where we come in! Book an assessment today with one of our Lifemark vestibular therapists so that we can perform a detailed assessment of your vestibular and balance system and help you get off the boat!  

Please visit www.lifemarkvestibular.ca for more information and locations.

Click here to watch a series of videos on the vestibular system, the most common causes of vertigo, dizziness and balance issues, and how to find relief: http://bit.ly/2A0V3k1