About Mal de Débarquement Syndrome

Mal de Débarquement Syndrome (MdDS) is a neurological disorder of perceived movement manifesting as a constant feeling of rocking, bobbing, or swaying which seems to be alleviated in passive motion such as riding in a car. This is an important diagnostic feature of the syndrome.

Also known as Disembarkment Syndrome, MdDS most often develops following a cruise or other type of water travel; exposure need not be sustained or lengthy. MdDS has also been reported following air, train, and automobile travel; and less commonly after repeated elevator use, walking on docks, from the use of virtual reality equipment, or practically any motion experience. MdDS occurs in both genders and in all age groups but current statistics demonstrate the highest reported incidence in females between the ages of 30 – 60. While MdDS most commonly presents itself after travel, for some onset appears to be spontaneous, without a motion event.

MdDS may persist for months to years, and there is a likelihood of recurrence after an initial onset. Many people experience the more common entity labelled “sea legs” upon alighting from travel experiences. “Sea legs” are a transient, normal response to travel which generally resolves quickly.

In addition to the rocking, bobbing, and/or swaying, there are many secondary symptoms. The sensation of motion is often associated with anxiety, fatigue, difficulty maintaining balance, unsteadiness, and difficulty concentrating (impaired cognitive function).

Symptoms usually begin shortly after the cessation of the motion stimulus, but occasionally there can be a delay between the end of travel and the onset of symptoms. The symptoms tend to be more noticeable in enclosed spaces or when attempting to be motionless (sitting, lying down, or standing in a stationary position).

Mal de Débarquement Syndrome does have a billing code found in the ICD-10. Find it here: 2018 ICD-10-CM Diagnosis Code R42.

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Is there an easier name than Mal de Débarquement Syndrome?

MdDS is the abbreviation for Mal de Débarquement Syndrome (Fr.), which translates to sickness upon disembarking (leaving a boat or other vehicle). This disorder is also known as Disembarkment Syndrome or colloquially as landsickness. It is less commonly known as Persistent Mal de Debarquement (PMdD), Rocking Dizziness or Rocking Vertigo.

I never went on a cruise. Can I have MdDS without a motion event?

Yes. While MdDS most often presents after a motion event (typically travel), about 20% of cases do not have a known causal event (i.e.: lack a motion trigger).  A connection between spontaneous onset and migraine, stress, or other non-motion event has been suggested but further research is required to make any correlations.

Suggested Reading

Cha YHMal de DebarquementSemin Neurol29:520-7, 2009. Review.

Who should I see to get diagnosed? GP or ENT?

MdDS is primarily diagnosed by otolaryngologists, ENTs and neurologists but can be diagnosed by your primary care provider. Other health professionals, including physical therapists and audiologists, may recognize the features of MdDS. A list of possible providers is available on this site. You may wish to bring our informative brochure to your appointment as many health care providers are unaware of MdDS.

Is there a cure?

Unfortunately, no.

You may be interested in the Physician’s Perspective blog post: Effective research requires teamwork.

Is there a treatment which prevents or reduces symptoms?

At present there are no treatments or therapies proven to be helpful to those suffering with MdDS. Some success in managing persistent symptoms has been realized with benzodiazepines, SNRIs, SSRIs and sometimes tricyclics. Vestibular rehabilitation therapy has shown effectiveness in a small number of patients, while a regular exercise program seems to help many.

Most anticholinergic medications that work for typical forms of dizziness and motion sickness, such as meclizine or scopolamine, are not effective in either treatment or prevention of MdDS. Further research is required for a greater understanding of the disorder.

Investigative treatments are available but limited, usually requiring travel. To learn about treatments that sufferers have explored, you may wish to join one of our support groups.

I’m 2 weeks out from a cruise and am still on the boat. When will this be over?

In most individuals, the sensation of rocking, bobbing, swaying, etc. following a cruise or other prolonged motion experience is transient. Symptoms lasting up to two weeks is considered within the normal range. A diagnosis of MdDS is usually only given to those whose symptoms last 30 days or more.

The symptoms of MdDS may gradually dissipate and disappear altogether. In general, this is more likely to happen for those who are younger. But, for a few and with age, symptoms may persist for an extended interval.

I have MdDS. Will symptoms become worse if I go on a cruise or undertake extended travel by air, train, or car?

Not necessarily. However, some individuals have described a transient increase in symptoms after these type of motion experiences. Some physicians suggest taking benzodiazepines to suppress the vestibular system during travel. While many patient members claim this course of action helps, clinical studies are required to prove their effectiveness across the population of MdDS sufferers.

I have had MdDS that resolved on its own. Will I develop this again if I go on another cruise?

Some individuals who have had MdDS that resolved redeveloped symptoms after a subsequent cruise (or other prolonged motion experience, depending on their unique triggers). However, there are some who did not. Many describe a more prolonged period of MdDS symptoms with each episode. Therefore, the recommendation is to avoid further cruises to minimize the likelihood that MdDS will recur.

Are MdDS symptoms worse during a woman’s period (menses)?

As with many chronic illnesses, many women experience increased symptoms before or during their menstrual cycle. MdDS is more common in women than men (9:1), however, the role of hormones in the exacerbation/remission of MdDS symptoms is not understood.

Are there any MdDS clinical trials/research studies?

This is a rare disorder and research studies are similarly rare. To our knowledge, there are only two active research studies on MdDS. One is being conducted at the Laureate Institute for Brain Research (LIBR) by Dr. Yoon-Hee Cha. The other is underway at Ohio University by Dr. Brian C. Clark. Both of these studies are funded, in part, by this Foundation.

Faces of MdDS

Be Still: a Poem by Farzleen

I am sharing my experience with fellow sufferers of this misunderstood condition because of how it took close to a year before a proper diagnosis was obtained after undergoing many tests, how frustrating and depressing it was prior to that not knowing what was actually happening to me, and for having people closest to me […]

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“Why do I feel like I am on a boat? Voila MdDS,” Elizabeth discovered.

In September 2017, my husband, my two sons (ages 20 and 21) and myself went on our first cruise, two weeks before the canaries Portugal Spain. All was well on the cruise, none of us were sea sick, but we did have rough days around the bay of biscay. On return home, my two sons […]

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LeeAnne suffers with dizziness that isn’t vertigo.

My name is LeeAnne and I have had MdDS for 5 years. After my third cruise, an 8-day cruise with rough seas, I noticed a change in my eye sight and had trouble reading the menus. And when I debarked I never got my land legs back. I saw my family doctor and explained my […]

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