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Ampomah KK, Clark BC, Arnold WD, Burwell D. An uncommon cause of headache and dizziness after cruise travel: case report of Mal De Debarquement syndrome. J Osteopath Med 2021; 121:471-474. [PMID: 33694342 DOI: 10.1515/jom-2020-0224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/18/2020] [Indexed: 11/15/2022]
Abstract
Mal de Debarquement syndrome (MdDS), also known as disembarkment syndrome, is a benign neurological condition characterized by a feeling of rocking, bobbing, or swaying, usually presenting after an individual has been exposed to passive motion as from being on a cruise, long drive, turbulent air travel, or train. Clinical awareness about this condition is limited, as is research; thus, many patients go undiagnosed. In this case report, the authors describe a case of a severe headache as a major presenting symptom of MdDS in a 46-year-old woman who eventually attained full resolution of symptoms. This report aims to highlight this unique presentation and make practitioners more aware of the cardinal clinical features, to assist in prompt diagnosis of this disorder.
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Affiliation(s)
- Kwasi K Ampomah
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University Heritage College of Osteopathic Medicine, Athens, USA.,Physical Medicine and Rehabilitation Department, Eastern Virginia Medical School, Norfolk, USA
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University Heritage College of Osteopathic Medicine, Athens, USA.,Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, USA
| | - William D Arnold
- Physical Medicine and Rehabilitation Department, Division of Neuromuscular Diseases, Department of Neurology, The Ohio State University in Columbus, Columbus, USA
| | - Daniel Burwell
- Department of Family Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, USA.,Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, USA
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Canceri JM, Brown R, Watson SR, Browne CJ. Examination of Current Treatments and Symptom Management Strategies Used by Patients With Mal De Debarquement Syndrome. Front Neurol 2018; 9:943. [PMID: 30483208 PMCID: PMC6240763 DOI: 10.3389/fneur.2018.00943] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/22/2018] [Indexed: 12/15/2022] Open
Abstract
Introduction: Mal de Debarquement Syndrome (MdDS) is a neurological disorder which affects the vestibular system pathways, manifesting as a constant sensation of movement in the form of rocking, bobbing, or swaying. The mechanism of MdDS is poorly understood and there is a lack of awareness amongst medical professionals about the condition. This study aimed to examine treatments and symptom management strategies used by MdDS patients and evaluate their self-reported effectiveness. Method: Motion-Triggered and Spontaneous/Other onset MdDS patients responded to a set of comprehensive questions as a retrospective survey regarding epidemiological details, diagnostic procedures, onset, and symptom triggers, hormonal influences as well as treatments and symptom management strategies used to reduce symptoms. The Motion-Triggered questionnaire was made available through Survey Monkey and the Spontaneous/Other Onset questionnaire through Qualtrics. The link for each questionnaire was made available on online MdDS support groups and on various research websites. Descriptive statistics were used for epidemiological data and Pearson's Chi Square tests were used for comparisons between and within both subtype groups. Results: A total of 370 patients participated in the surveys, with 287 valid responses collected for the section regarding treatment and symptom management strategies. The success of the treatments and symptom management strategies did not vary between subtypes Benzodiazepines/Antidepressants were reported as being most beneficial in reducing symptoms in both groups. Conclusion: This was the first attempt to evaluate the reported success of treatments and symptom management strategies in MdDS patients by assessing the patients' perceived helpfulness. The treatments and symptom management strategies reported to be the most helpful in managing and/or reducing symptoms are proposed to be effective due to their stress-reducing capacities. We hope this study will broaden MdDS awareness and that this study will increase patient knowledge regarding treatments and symptom management strategies that other patients found helpful.
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Affiliation(s)
- Josephine M Canceri
- School of Science and Health, Western Sydney University, Sydney, NSW, Australia
| | - Rachael Brown
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Shaun R Watson
- Prince of Wales Private Hospital, Sydney, NSW, Australia
| | - Cherylea J Browne
- School of Science and Health, Western Sydney University, Sydney, NSW, Australia.,Translational Neuroscience Facility, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
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Mucci V, Canceri JM, Brown R, Dai M, Yakushin S, Watson S, Van Ombergen A, Topsakal V, Van de Heyning PH, Wuyts FL, Browne CJ. Mal de Debarquement Syndrome: a survey on subtypes, misdiagnoses, onset and associated psychological features. J Neurol 2018; 265:486-499. [PMID: 29305644 PMCID: PMC5834551 DOI: 10.1007/s00415-017-8725-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 02/07/2023]
Abstract
Introduction Mal de Debarquement Syndrome (MdDS) is a neurological condition typically characterized by a sensation of motion, that persists longer than a month following exposure to passive motion (e.g., cruise, flight, etc.). The most common form of MdDS is motion triggered (MT). However, recently it has been acknowledged that some patients develop typical MdDS symptoms without an apparent motion trigger. These cases are identified here as spontaneous or other onset (SO) MdDS. This study aimed to address similarities and differences between the MdDS subtypes. Diagnostic procedures were compared and extensive diagnostic guidelines were proposed. Second, potential triggers and associated psychological components of MdDS were revealed. Methods This was a retrospective online survey study for MT and SO MdDS patients. Participants were required to respond to a set of comprehensive questions regarding epidemiological details, as well as the diagnostic procedures and onset triggers. Results There were 370 patients who participated in the surveys. It is indicated that MdDS is often misdiagnosed; more so for the SO group. In addition to the apparent self-motion, both groups reported associated levels of stress, anxiety and depression. Discussion It appears at present that both MdDS subtypes are still poorly recognised. This was the first attempt to evaluate the diagnostic differences between MdDS subtypes and to propose a set of comprehensive diagnostic guidelines for both MdDS subtypes. In addition, the current research addressed that associated symptoms such as stress, anxiety and depression should also be considered when treating patients. We hope this study will help the medical community to broaden their awareness and diagnostic knowledge of this condition. Electronic supplementary material The online version of this article (10.1007/s00415-017-8725-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- V Mucci
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA) Antwerp, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - J M Canceri
- School of Science and Health, Western Sydney University, Sydney, NSW, Australia
| | - R Brown
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - M Dai
- Icahn School of Medicine, Mount Sinai Hospital, New York City, NY, USA
| | - S Yakushin
- Icahn School of Medicine, Mount Sinai Hospital, New York City, NY, USA
| | - S Watson
- Prince of Wales Private Hospital, Sydney, NSW, Australia
| | - A Van Ombergen
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA) Antwerp, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - V Topsakal
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - P H Van de Heyning
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA) Antwerp, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - F L Wuyts
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA) Antwerp, University of Antwerp, Antwerp, Belgium
| | - C J Browne
- School of Science and Health, Western Sydney University, Sydney, NSW, Australia.
- Translational Neuroscience Facility, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia.
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Van Ombergen A, Van Rompaey V, Maes LK, Van de Heyning PH, Wuyts FL. Mal de debarquement syndrome: a systematic review. J Neurol 2015; 263:843-854. [PMID: 26559820 PMCID: PMC4859840 DOI: 10.1007/s00415-015-7962-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 10/27/2015] [Accepted: 10/28/2015] [Indexed: 11/28/2022]
Abstract
Mal de debarquement (MdD) is a subjective perception of self-motion after exposure to passive motion, in most cases sea travel, hence the name. Mal de debarquement occurs quite frequently in otherwise healthy individuals for a short period of time (several hours). However, in some people symptoms remain for a longer period of time or even persist and this is then called mal de debarquement syndrome (MdDS). The underlying pathogenesis is poorly understood and therefore, treatment options are limited. In general, limited studies have focused on the topic, but the past few years more and more interest has been attributed to MdDS and its facets, which is reflected by an increasing number of papers. Till date, some interesting reviews on the topic have been published, but a systematic review of the literature is lacking and could help to address the shortcomings and flaws of the current literature. We here present a systematic review of MdD(S) based on a systematic search of medical databases employing predefined criteria, using the terms “mal de debarquement” and “sea legs”. Based on this, we suggest a list of criteria that could aid healthcare professionals in the diagnosis of MdDS. Further research needs to address the blank gaps by addressing how prevalent MdD(S) really is, by digging deeper into the underlying pathophysiology and setting up prospective, randomized placebo-controlled studies to evaluate the effectiveness of possible treatment strategies.
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Affiliation(s)
- Angelique Van Ombergen
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Groenenborgerlaan 171, 2020, Antwerp, Belgium.
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
- Faculty of Sciences, Department of Physics, University of Antwerp, Antwerp, Belgium.
| | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology, Antwerp University Hospital, Wilrijkstraat 10, Edegem (Antwerp), Belgium
| | - Leen K Maes
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Groenenborgerlaan 171, 2020, Antwerp, Belgium
- Faculty of Sciences, Department of Physics, University of Antwerp, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Paul H Van de Heyning
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Groenenborgerlaan 171, 2020, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology, Antwerp University Hospital, Wilrijkstraat 10, Edegem (Antwerp), Belgium
| | - Floris L Wuyts
- Antwerp University Research Centre for Equilibrium and Aerospace (AUREA), University of Antwerp, Groenenborgerlaan 171, 2020, Antwerp, Belgium
- Faculty of Sciences, Department of Physics, University of Antwerp, Antwerp, Belgium
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