Clinical features and associated syndromes of mal de debarquement
- 315 Downloads
To investigatethe clinical features and naturalhistory of mal de debarquement(MdD).
Retrospective casereview with follow-up questionnaireand telephone interviews.
University Neurotology Clinic.
Patients seen between1980 and 2006 who developed apersistent sensation of rocking orswaying for at least 3 days after exposureto passive motion.
Main outcome measure
Clinical features,diagnostic testing, and questionnaireresponses.
Of 64 patients(75 % women) identifiedwith MdD, 34 completed follow-upquestionnaires and interviews in2006. Most patients had normalneurological exams, ENGs andbrain MRIs. The average age of thefirst MdD episode was 39 ± 13years. A total of 206 episodes wereexperienced by 64 patients. Ofthese, 104 episodes (51 %) lasted> 1 month; 18 %, > 1 year; 15 %, > 2years; 12 %, > 4 years, and 11 %, > 5years. Eighteen patients (28 %) subsequentlydeveloped spontaneousepisodes of MdD-like symptomsafter the initial MdD episode.There was a much higher rate ofmigraine in patients who went onto develop spontaneous episodes(73 %) than in those who did not(22 %). Subsequent episodes werelonger than earlier ones in mostpatients who had multiple episodes.Re-exposure to passivemotion temporarily decreasedsymptoms in most patients (66 %).Subjective intolerance to visualmotion increased (10 % to 66 %)but self-motion sensitivity did not(37 % to 50 %) with onset of MdD.
The majority of MdDepisodes lasting longer than 3 daysresolve in less than one year but theprobability of resolution declineseach year. Many patients experiencemultiple MdD episodes. Somepatients develop spontaneousepisodes after the initial motiontriggeredepisode with migrainebeing a risk factor.
Key wordsmal de debarquement vestibular adaptation motion sensitivity visual motion migraine
- 2.Britton TC, Day BL, Brown P, RothwellJC, Thompson PD, Marsden CD (1993)Postural electromyographic responsesin the arm and leg following galvanicvestibular stimulation in man. ExpBrain Res 94:143–151Google Scholar
- 4.Flanagan MB, May JG, Dobie TG (2004)The role of vection, eye movementsand postural instability in the etiologyof motion sickness. J Vest Res 14:335–346Google Scholar
- 7.Hain TC, Hanna PA, Rheinberger MA(1999) Mal de Debarquement. ArchOtolaryngol Head Neck Surg 125:615–620Google Scholar
- 8.Headache Classification Subcommitteeof the International Headache Society(2004) The International Classificationof Headache Disorders 2nd edition.Cephalalgia 24(Suppl 1):1–160Google Scholar
- 14.Mair IWS (1996) The mal de debarquementsyndrome. J Audiol Med 5:21–25Google Scholar
- 18.Reason JT (1978) Motion sicknessadaptation: a neural mismatch model.Journal of the Royal Society ofMedicine 71:819–829Google Scholar