- Mal de debarquement
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Mal de debarquement (or Mal de débarquement) 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 received attention and very little real scientific research has been conducted. The phrase "mal de débarquement" is French for "disembarkation sickness".
Contents
Symptoms
Symptoms most frequently reported include a persistent sensation of motion usually described as rocking, swaying, or bobbing; difficulty maintaining balance; extreme fatigue; and difficulty concentrating ("brain fog"). Other common symptoms include dizziness, visual disturbances (such as seeing motion, inability to focus etc.), headaches and/or migraine headaches, confusion, and anxiety. Many patients also describe ear symptoms such as hyperacusis, tinnitus, "fullness", pain, or even decreased hearing. Cognitive impairment ("brain fog") includes an inability to recall words, short term memory loss, and an inability to multi-task.
Interestingly, the condition often abates when the patient is in motion such as in a car, train, plane, or boat. Symptoms are increased by stress, lack of sleep, crowds, flickering lights, loud sounds, fast or sudden movements, enclosed areas or busy patterns.
In MdDS, the symptoms persist for more than a month, possibly for many years, and sometimes do not resolve at all. This differs from the very common condition of "land sickness" that most people feel for a short time after a motion event such as a boat cruise, aircraft ride, or even a treadmill routine.
MdDS is thought to be a neurological syndrome with no known cause or cure. Research is being undertaken into the neurological nature of this syndrome through imaging studies.
Epidemiology
The condition is felt to be under-reported 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.
These trends have recently been confirmed by the MdDS Balance Disorder Foundation[1] in a study of over 100 individuals diagnosed with MdDS. The female:male ratio was approximately 9:1; the average age of onset was 43–45 years.
The most commonly reported inciting event was a prolonged ocean cruise (~45%), however shorter boating excursions (~22%), aircraft travel (~15%), and automobile travel (~8%) have all been described.
Diagnosis
MdDS is a diagnosis of exclusion. There are no definitive tests that 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 three 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 bicycle). This has not been well-studied in MdDS however. Medications that suppress the nerves and brain circuits involved in balance (the benzodiazepine clonazepam for example) have been noted to help, but don't seem to offer a permanent cure. Due to lack of research, it is not known at this point whether medication that supress symptoms prolong symptom-duration or not.
Individuals with balance disorders should not allow this to affect their mobility, as this will then cause a superimposed "disuse imbalance" or contribute to weight gain and depression. A vicious cycle may ensue.[citation needed]
See also
References
- Yoon-Hee Cha, MD,1 Jae Brodsky, MS,2 Gail Ishiyama, MD,1 Chiara Sabatti, PhD,3 and Robert W. Baloh, MD "Clinical features and associated syndromes of mal de debarquement", J Neurol. 2008 July; 255(7): 1038.
Published online 2008 May 30. doi: 10.1007/s00415-008-0837-3.
- Hain TC, Hanna PA, and Rheinberger MA. "Mal de debarquement", Archives of Otolaryngology - Head & Neck Surgery. 1999 Jun;125(6):615-20.
External links
Categories:- Rare diseases
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