What is 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 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.

Download a PDF of our brochure, or request printed copies by contacting us.

FAQs

With MdDS remission, do symptoms decrease gradually or disappear suddenly?

New members to our support groups often ask, “For those of you who went into remission, did your MdDS symptoms decrease gradually over time, or did they disappear suddenly?”

Some experience relief every other day, and the number of good days increases until there are no bad days. But generally, symptoms wane gradually.

Are there similar conditions? What are some other balance disorders?

According to the National Institute on Deafness and Other Communication Disorders, there are more than a dozen different balance disorders. The NIDCD website provided the following information on a few similar conditions:

  • Benign paroxysmal positional vertigo (BPPV) or positional vertigo: A brief, intense episode of vertigo triggered by a specific change in the position of the head. You might feel as if you’re spinning when you bend down to look under something, tilt your head to look up or over your shoulder, or roll over in bed. BPPV occurs when loose otoconia tumble into one of the semicircular canals and affect how the cupula works. This keeps the cupula from flexing properly, sending incorrect information about your head’s position to your brain, and causing vertigo.
  • Labyrinthitis: An infection or inflammation of the inner ear that causes dizziness and loss of balance. It is often associated with an upper respiratory infection, such as the flu.
  • Ménière’s disease: Episodes of vertigo, hearing loss, tinnitus (a ringing or buzzing in the ear), and a feeling of fullness in the ear. It may be associated with a change in fluid volume within parts of the labyrinth, but the cause or causes are still unknown.
  • Vestibular neuronitis: An inflammation of the vestibular nerve that can be caused by a virus, and primarily causes vertigo.
  • Perilymph fistula: A leakage of inner ear fluid into the middle ear. It causes unsteadiness that usually increases with activity, along with dizziness and nausea. Perilymph fistula can occur after a head injury, dramatic changes in air pressure (such as when scuba diving), physical exertion, ear surgery, or chronic ear infections. Some people are born with perilymph fistula.

Symptoms of these conditions do not abate when the patient is in motion. A key diagnostic indicator of MdDS is that symptoms often temporarily remit when the patient is back in motion.

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.

How did I get MdDS? 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.

How do I get an MdDS diagnosis? Should I see a 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 for MdDS?

Unfortunately, no, but there are several on-going research studies.

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

Is there a treatment to prevent or reduce MdDS 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.

How long does MdDS last? I’m 2 weeks out from a cruise and am still on the boat.

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

I Look Normal, by Tami G.

I wrote this poem a number of years ago (maybe 5 years ago) and I sometimes post it as a status update. My daughter is no longer a toddler but the rest holds true. ~ Tami Grosset I look normal. I sit in my chair and chat. I giggle and gossip just like I’ve always […]

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If you are a sibling, parent, child, friend, or caregiver to someone dealing with chronic illness, chances are you may ask yourself occasionally — or nonstop — How can I help? As a full-time caregiver to my wife, and also as a person with MdDS, I’ve written this guide which I hope will help you […]

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We can do this. I believe in you! ~ Katie

My name is Katie Miller, and I have had MdDS since 2002. I took two short, uneventful flights on a Friday and two similar flights back on the following Sunday. I woke up that Monday with the unnerving sensation of walking on mattresses, and it looked like the walls were moving. I had absolutely no […]

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About the Disorder & FAQ MdDS Foundation 8:02 am