Mal de debarquement

Mal de debarquement syndrome (MdDS, or disembarkment syndrome) is a rare condition usually occurring after a cruise, aircraft flight, or other sustained motion event. It has only recently gotten attention and very little real scientific research has been conducted. The phrase "mal de debarquement" is French for "sickness of disembarkation".

Symptoms
Symptoms most frequently reported include a persistent sensation of motion usually described as rocking, swaying, or bobbing; extreme fatigue; vomiting; imbalance; and "brain fog". Most patients also complain of ear symptoms such as hyperacusis, tinnitus, "fullness", pain, or even decreased hearing. Cognitive disfunction is much less confirmed but anecdotal reports link this condition to an inability to recall words, short term memory loss, and an inability to multi-task.

Most interestingly the condition often abates transiently when the patient resumes cruising, flies in a plane, travels by car, or even walks quickly.

In MdDS the symptoms persist for more than 1 month, and possibly many years. This differs from the very common condition of "land sickness" than most people feel for a short time after a motion event such as a boat cruise, airplane ride, or even a treadmill routine.

Epidemiology
The condition is felt to be underreported in the medical literature, where fewer than 100 cases have been studied. A series of 27 cases reported in 1999 (Hain et al. 1999) noted all but one patient to be female. The average age in this series was 49 years. The most commonly reported inciting event is a prolonged ocean cruise, however shorter cruises, river cruises and airplane travel have all been reported.

Diagnosis
MdDS is a diagnosis of exclusion. There are no definitive tests the confirm MdDS, only tests that rule out other conditions.

Treatment
There is no known cure for the condition. In the series cited above, more than 50% of patients had resolution of symptoms within 3 years of onset. For most balance and gait disorders, some form of displacement exercise is thought helpful (for example walking, jogging, or bicycling but not on a treadmill or stationary bictcle). This has not been well-studied in MdDS however. Medications that suppress the nerves and brain circuits involved in balance have been noted to help, but don't seem to offer a permanent cure.

The worst thing a person can do is let a balance disorder limit his or her physical activity, as this will then cause a superimposed "disuse imbalance" or contribute to weight gain and depression. A vicious cycle may ensue.