Mal de Debarquement Syndrome

Mal de Debarquement Syndrome (MdDS) is a rare condition where you feel a persistent sensation of motion, like rocking, swaying, or bobbing, even when you are standing still. This feeling usually starts after you have been exposed to continuous motion, such as a long boat trip. MdDS is not a mental health condition and can significantly affect daily life.

What is Mal de Debarquement Syndrome?

Mal de Debarquement Syndrome (MdDS) is a rare disorder that makes you feel like you are still moving, even when you are not. This sensation is often described as rocking, swaying, or bobbing, similar to being on a boat. It typically begins after exposure to sustained motion, such as sea travel, and can last for months or even years, impacting daily activities.

MdDS is a unique condition because the feeling of motion continues long after the actual motion has stopped. For example, after getting off a cruise ship, someone with MdDS might still feel like they are on the water, even weeks or months later. This persistent sensation is not due to a psychological problem. The name "Mal de Debarquement" is French for "sickness of disembarkment." While it most commonly occurs after sea travel, some people develop MdDS after other forms of motion, such as long car rides, train trips, or even using a waterbed. The condition is considered rare, and its exact mechanisms are still being studied by medical researchers.

Symptoms

The main symptom of Mal de Debarquement Syndrome (MdDS) is a constant, internal feeling of motion, such as rocking, swaying, or bobbing, even when you are still. This sensation often gets worse when you are resting or in quiet environments and may temporarily improve with passive motion, like riding in a car. Other symptoms can include fatigue, headaches, and difficulty concentrating.

People with MdDS often describe the sensation as if they are walking on a trampoline or a boat deck. This feeling is typically worse when they are sitting or lying down and in places with a lot of visual stimulation, like grocery stores. Surprisingly, some people find that the symptoms lessen when they are actively moving or riding in a vehicle. Beyond the primary sensation of motion, MdDS can cause other challenging symptoms. These include feeling tired all the time (fatigue), having headaches, and struggling to focus or pay attention (difficulty concentrating). Some individuals also experience anxiety or feel off-balance, which can make everyday tasks difficult and reduce their quality of life.

Causes & risk factors

The exact cause of Mal de Debarquement Syndrome (MdDS) is not fully understood, but it is believed to occur when the brain fails to properly reset after adapting to continuous motion. This means the brain continues to perceive motion even when it's no longer present. While anyone can develop MdDS, it is more common in women, typically between 30 and 60 years old, and a history of migraines or motion sickness may increase the risk.

Normally, your brain quickly adjusts to new movements, like the rocking of a boat, and then readjusts when the movement stops. In MdDS, this readjustment process does not happen correctly. Your brain's balance system (vestibular system) seems to get stuck in the "motion" mode, leading to the persistent sensation of movement. Several factors have been identified that may increase a person's risk of developing MdDS. Women are more likely to experience the condition than men. It also tends to affect people in their middle age, usually between 30 and 60 years old. Individuals who have a history of migraines, frequent motion sickness, or anxiety may also have a higher chance of developing MdDS after motion exposure.

How it's diagnosed

Diagnosing Mal de Debarquement Syndrome (MdDS) can be challenging because there is no specific test for it. Doctors diagnose MdDS based on your symptoms, a detailed medical history, and by ruling out other conditions that could cause similar symptoms. This process often involves various tests to ensure that the symptoms are not due to another underlying health issue.

When you see a doctor for symptoms of MdDS, they will ask about your experiences, including when the symptoms started, what makes them better or worse, and any recent travel or motion exposure. They will also perform a physical exam and may order tests such as blood work, imaging scans of the brain (like an MRI), or balance tests. The purpose of these tests is not to confirm MdDS, but rather to exclude other potential causes of dizziness or imbalance. Conditions like inner ear problems, certain neurological disorders, or even some medications can cause symptoms similar to MdDS. Once other conditions have been ruled out, and your symptoms match the typical presentation of MdDS, a diagnosis can be made.

Treatment options

Currently, there is no cure for Mal de Debarquement Syndrome (MdDS), so treatments focus on managing the symptoms. Medications like benzodiazepines, which can help calm the nervous system, or certain antidepressants (selective serotonin reuptake inhibitors, or SSRIs) may be prescribed to reduce the sensation of motion or associated anxiety. Vestibular rehabilitation, a type of physical therapy, can also be helpful for some individuals.

Medications are often the first line of treatment for MdDS. Benzodiazepines, such as clonazepam, are sometimes used because they can help reduce the feeling of motion and calm the brain's overactive balance signals. However, these medications can have side effects and may not be suitable for long-term use. Antidepressants, specifically SSRIs, may also be prescribed, especially if anxiety or depression are significant symptoms. Another treatment approach is vestibular rehabilitation, which involves specific exercises designed to help your brain re-learn how to process balance information correctly. A physical therapist specializing in vestibular disorders can guide you through these exercises. While not effective for everyone, some people with MdDS find significant relief through this therapy. Repetitive transcranial magnetic stimulation (rTMS) is also being explored as an experimental treatment, showing promise in some studies, but more research is needed to confirm its effectiveness.

Recovery & outlook

The recovery and outlook for Mal de Debarquement Syndrome (MdDS) vary greatly among individuals. For some people, symptoms may gradually lessen over time and eventually disappear completely. However, for others, MdDS can become a chronic (long-lasting) condition, with symptoms persisting for many years or even indefinitely. While there is no guaranteed cure, treatments can help manage symptoms and improve quality of life.

It is important to understand that MdDS can be a challenging condition to live with, and its course is unpredictable. Some individuals experience spontaneous remission, meaning their symptoms resolve on their own without specific treatment. This can happen weeks or months after the onset of symptoms. For those who experience chronic MdDS, the condition can significantly impact daily activities, work, and social life. While symptoms may not disappear entirely, managing them with medication, therapy, and lifestyle adjustments can help improve comfort and function. Researchers continue to study MdDS to better understand its mechanisms and develop more effective treatments, offering hope for future improvements in outlook.

When to see a doctor

You should see a doctor if you experience persistent dizziness or a sensation of motion, especially if it begins after travel or other motion exposure. It is crucial to get a medical evaluation to rule out other serious conditions that can cause similar symptoms. Seek immediate medical attention if your dizziness is accompanied by severe headache, weakness, numbness, difficulty speaking, or changes in vision, as these could indicate an emergency.

Any new or persistent feeling of dizziness or imbalance warrants a visit to your healthcare provider. While it might be MdDS, these symptoms can also be signs of other medical issues that require prompt diagnosis and treatment. Your doctor can conduct a thorough examination and recommend appropriate tests to determine the cause of your symptoms. It is especially important to seek urgent medical care if your dizziness or motion sensation is accompanied by other concerning symptoms. These include a sudden, severe headache; weakness or numbness on one side of your body; trouble speaking or understanding speech; double vision or sudden vision loss; or difficulty walking. These symptoms could point to a stroke or other serious neurological problem that needs immediate attention.

Frequently asked questions

Can Mal de Debarquement Syndrome go away on its own?

Yes, for some people, the symptoms of Mal de Debarquement Syndrome (MdDS) can gradually lessen over time and even disappear completely without specific treatment. This is known as spontaneous remission. However, for others, the condition can be chronic and last for many years.

Is Mal de Debarquement Syndrome a psychological condition?

No, Mal de Debarquement Syndrome (MdDS) is not considered a psychological or mental health condition. It is a neurological disorder related to how the brain processes balance and motion. While anxiety can be a symptom, it is not the cause of MdDS.

Can I prevent Mal de Debarquement Syndrome?

Currently, there are no known ways to prevent Mal de Debarquement Syndrome (MdDS). Since the exact cause is not fully understood, and it often occurs after common activities like travel, specific prevention strategies are not available. If you have risk factors like migraines, discuss them with your doctor.

Are there any natural remedies for MdDS?

The provided sources do not mention specific natural remedies for Mal de Debarquement Syndrome (MdDS). Treatment typically focuses on medications and vestibular rehabilitation. Always consult your doctor before trying any new treatments, including natural remedies, to ensure they are safe and appropriate for your condition.

Does Mal de Debarquement Syndrome affect driving?

Yes, Mal de Debarquement Syndrome (MdDS) can affect driving. The persistent sensation of motion and potential imbalance can make it unsafe to drive. Paradoxically, some people find that the symptoms temporarily improve while riding in a car. Always discuss your symptoms with your doctor to determine if driving is safe for you.

What is the difference between MdDS and regular motion sickness?

Regular motion sickness occurs during or shortly after motion exposure and typically resolves quickly once the motion stops. Mal de Debarquement Syndrome (MdDS), however, involves a persistent sensation of motion that continues for weeks, months, or even years after the actual motion has ended. It is a prolonged and often debilitating condition.

Sources

• MedlinePlus — Mal de Debarquement Syndrome
• Mayo Clinic — Mal de Debarquement Syndrome
• Cochrane Library — Mal de Debarquement Syndrome