FAQs

MdDS is a central vestibular (neurological) disorder. It is not a peripheral vestibular (inner ear) disorder or a disease. Parts of the brain associated with MdDS are discussed in the research article, Metabolic and Functional Connectivity Changes in Mal de Debarquement Syndrome, author Yoon-Hee Cha, MD, et al.

What does MdDS stand for?

MdDS is the acronym for Mal de Débarquement Syndrome, which is French and translates to sickness upon disembarking (leaving a boat or other vehicle). The disorder is also known as Disembarkment Syndrome in English. Other names include Persistent Mal de Debarquement (PMdD), Rocking Dizziness, Rocking Vertigo, disembarkation syndrome, and debarquement syndrome.

Erasmus Darwin (grandfather to Charles Darwin) included a description of MdDS under the “Vertigo” section of his medical tome Zoonomia in 1796. However, it wasn’t until almost 200 years later that the disorder was officially named by neurologist Dr. Jeffrey J. Brown. The first research article in modern biomedical literature, “Persistent mal de debarquement syndrome: a motion-induced subjective disorder of balance” by Brown and Baloh, was published in 1987.

Can the name be changed?

While newer research acknowledges that MdDS is not only motion-induced—and that many patients suffer with no associated motion event—the name of the disorder is established in clinical and research settings.

There is no single test to definitively prove you have MdDS. Instead, a diagnosis is made based on your medical history and by running tests to exclude (rule out) other potential causes for your symptoms.

Key diagnostic indicators include a persistent perception of rocking, bobbing, swaying and/or gravitational pull that lasts for at least 30 days, and the sensation temporarily improves when you are in passive motion (such as driving or riding in a car).

How to Get a Diagnosis

While your Primary Care Provider (PCP) can diagnose MdDS, it is most commonly diagnosed by specialists such as otolaryngologists (Ear, Nose, and Throat doctors) or neurologists. Other health professionals, including physical therapists and audiologists, may recognize the features of MdDS.

Many healthcare providers are familiar with MdDS. To help your provider make an accurate diagnosis, use these strategies during your visit:

• Describe the perception of movement accurately: Avoid using broad terms like “dizzy” or “vertigo.” Instead, describe the specific feeling, such as feeling like you are on a boat, walking on a trampoline, or experiencing an elevator drop.
• Highlight your medical history: Clearly mention if your symptoms began after a cruise, flight, train ride, or other motion event, and note if the sensations temporarily disappear when you are back in a moving vehicle.*
• Bring educational resources: Consider printing and bringing our informative brochure or the MdDS diagnostic criteria to your appointment to share with your doctor. These resources include official ICD billing codes, which can validate your experience and help guide your provider through the diagnosis process.

*Note: A subset of individuals develop non-motion triggered or “spontaneous” MdDS, exhibiting identical symptoms without an associated motion event. See also “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 motion trigger or known causal event. A connection between spontaneous onset MdDS and migraine, stress, or other non-motion event has been suggested but further research is required to make any correlations.

Suggested Reading:

Cha YH. Mal de Debarquement. Semin Neurol, 29:520-7, 2009. Review.

How long does it take for MdDS to go away?

In most individuals, the perception of rocking, bobbing, swaying, etc. following a cruise or other passive motion experience is transient. Symptoms lasting up to two weeks are considered within the normal range. usually resolve on their own. A diagnosis of MdDS is usually only given when symptoms last 30 days or more.

MdDS is often self-limiting, with symptoms typically resolving on their own within 4 months (median duration according to Cha et al, 2008).

MdDS may be episodic.

Patients in remission (no perception of motion for 6 months) may experience recurring bouts, often associated with a precipitating event, e.g., travel or high stress. Subsequent episodes are generally more prolonged but some patients experience a quick return to baseline.

The Key Distinction: Motion sickness is a transient physiological response to motion that resolves quickly. In contrast, Mal de Débarquement Syndrome is a neurological disorder where symptoms persist for at least 30 days.

While both conditions involve spatial disorientation, MdDS and motion sickness are distinct in their attributes and suspected mechanisms. Understanding the distinction between motion sickness and MdDS can help guide your management path.

Not necessarily. Some individuals whose MdDS had resolved redeveloped symptoms after a subsequent cruise or motion experience, while others did not.

Some individuals report a temporary increase in symptoms after subsequent travel, and many describe a more prolonged period of symptoms with each consecutive episode. Therefore, the recommendation is to avoid further cruises to minimize the likelihood of recurrence.

Your physician may suggest using benzodiazepines to suppress the vestibular system during travel. While many patients claim this helps, clinical studies are required to prove effectiveness across the broader MdDS population.

Whether the duration or intensity of initial symptoms influences the likelihood of recurrence remains unknown. The MdDS Patient Registry launching in 2026 aims to collect data to better answer questions like this one. Learn more about the Registry on this page.

It is common for individuals with various chronic conditions to notice a temporary increase in baseline symptoms during hormonal fluctuations, such as the menstrual cycle. However, a temporary increase in symptoms does not mean hormones cause the disorder.

While MdDS is more frequently diagnosed in women, a definitive link to hormones has not been established. The biological factors involved in the development, exacerbation, or remission of MdDS are not fully understood. The MdDS Patient Registry (coming in 2026) aims to collect data that will help researchers better evaluate any patterns based on clinical evidence rather than speculation.

Generally, symptoms wane gradually. Some experience relief every other day with the number of good days increasing until there are no bad days. As a given course of MdDS progresses toward remission, symptoms lessen in severity and intervals of symptom-free periods become more frequent and prolonged. Patients with 0 perception of motion, sustained for at least six months, are considered in remission.

The MdDS Foundation is working to improve understanding of remission and address key questions about MdDS by collecting patient data through a patient registry. The data will be analyzed to provide valuable insights, which will be shared with patients, clinicians, and researchers. Learn more about the MdDS Patient Registry and its potential impact here.

At present, there is no universally effective treatment or cure for Mal de Débarquement Syndrome. Because no medications have been developed specifically for MdDS, prescription therapies are used off-label—meaning they are approved for other conditions but may help manage MdDS symptoms.

• Medical Management: Some patients experience symptom reduction with benzodiazepines, SNRIs, SSRIs, and occasionally tricyclic antidepressants. These are typically determined through careful clinical trial and error with your physician.

• What Does Not Work: Standard anti-motion sickness or anticholinergic medications (such as meclizine or scopolamine) are ineffective for both the prevention and treatment of MdDS.

• Non-Pharmacological Options: Vestibular rehabilitation therapy has shown effectiveness in a small number of patients, while regular exercise programs help many manage persistent symptoms.

Investigative treatments and ongoing biomedical research continue to explore new targeted therapies. Always consult your healthcare provider before starting or altering any treatment plan.

For firsthand accounts and insights, you may wish to join our support group to learn about treatments that others have explored and found helpful.

While there is currently no cure for MdDS, research is continuously advancing with ongoing studies. Finding a definitive solution takes time, and as highlighted in the Physician’s Perspective blog post, Effective research requires teamwork.

In the meantime, managing symptoms is possible, and many individuals find relief using the strategies outlined in our Coping Tips.

A new study is coming in the form of a patient registry. Past research studies include one conducted at the University of Minnesota by Dr. Yoon-Hee Cha and at Ohio University by Dr. Brian C. Clark, both funded in part by the Foundation.

Comprehensive information on clinical studies can be found on the NIH ClinicalTrials.gov website. To review the peer-reviewed papers and formal outcomes generated by these and other studies, explore our Biomedical Literature repository.

A patient registry for Mal de Débarquement Syndrome is under construction. We are working towards launching in 2026, on the NORD IAMRARE research and data platform.

A patient registry is a centralized location where patients provide their unique data. By continuing to add data at intervals, a picture of that patient’s medical condition may emerge. A generalized “natural history” of the condition may be revealed as well. When made available to researchers and clinicians as de-identified, aggregated patient data, improvements in patient care, treatments, and potentially cures may be developed.

What is a balance disorder?

The National Institute on Deafness and Other Communication Disorders (NIDCD) defines a balance disorder as a condition that makes you feel unsteady or dizzy. If you are standing, sitting, or lying down, you might feel as if you are moving, spinning, or floating. If you are walking, you might suddenly feel as if you are tipping over. The NIDCD adds that there are more than a dozen different balance disorders. Here are just a few common balance disorders.

• 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. Read More.
• 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. Read More.
• 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. Read More.
• Vestibular neuronitis: An inflammation of the vestibular nerve that can be caused by a virus, and primarily causes vertigo. Read More.
• 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. Read More.
• Persistent Postural-Perceptual Dizziness (PPPD): see diagnostic criteria established by the Bárany Society and International Headache Society. The document is available through the Journal of Vestibular Research.
• Vestibular Migraine: see diagnostic criteria established by the Bárany Society and International Headache Society. The document is available through the Journal of Vestibular Research.

Other balance disorders may have symptoms in common with MdDS but, of note, 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. When discussing your symptoms with your doctor, it is best to not use the words “dizzy” or “vertigo.” Instead, explain that you feel as if you are on a boat, walking on a trampoline or mattress, elevator drop, or other descriptive language.

Diagnostic Criteria for MdDS established by the Committee for the Classification of Vestibular Disorders of the Bárány Society can be found in the Journal of Vestibular Research.

What is vertigo?

Vertigo may be defined as a disorder of the sense of any direction, a disturbed spatial perception of the body, but vertigo usually means dizziness with spinning, a rotational sensation. And a frequent outcome when using the words “dizzy,” “dizziness” or “vertigo” when speaking with your doctor is a misdiagnosis with one of the above common balance disorders. A standard definition is being established by the Bárany Society of Neuro-Otology.