MdDS is primarily diagnosed by an otolaryngologist or neurologist using patient history (such as a recent boat, air or train travel or other motion experience) and the elimination of other disorders which may have similar symptoms. Diagnosis may also be made by your primary care provider or other health professional, physical therapists or audiologists for example, who recognizes the features of MdDS.
We recommend bringing our educational brochure with you to your appointment. Although MdDS is listed in the International Classification of Diseases (ICD) under Dizziness and Giddiness, avoid using the words “dizzy” or “vertigo” when describing your symptoms. Many have better success getting their doctor to understand when they say, “I feel like I am rocking, as if on a boat” or similar.
While there are internationally recognized Diagnostic Criteria for MdDS, presently there are no tests that can provide a definitive diagnosis of MdDS. Your doctor will probably want to rule out other disorders that may have similar symptoms. Tests used to exclude other disorders may include the following:
- Neurological examination
- ENG test (electronystagmography)
- Videonystagmography (VNG)
- Rotary chair test
- Caloric Stimulation (air or water)
- Blood tests (CBC, blood glucose, vitamin B12)
- Blood tests for autoimmune disorders that may involve the ear
- ANA (anti-nuclear antibodies)
- TSH (thyroid stimulating hormone)
- anti-microsomal antibodies
- anti-cochlear antibodies
- HLA-DR determinations
- MRI of the brain and/or MRA of the brain stem and neck
- ECOG – if hearing is abnormal
- High resolution cat scan to rule out small fistulas or superior canal dehiscence syndromes, especially if history of barotrauma.
- Optokinetic after-nystagmus: scroll down to the “Additional Applications” section in Applications of the Rotational Chair
It is common for test results to be entirely normal for people suffering with MdDS. Because of this, many patients commonly go undiagnosed or are misdiagnosed. Consult your physician to determine which tests are best for you.
While some success in managing symptoms has been realized with medications and vestibular rehabilitation, a treatment that is universally beneficial has yet to be found.
- Anticholinergic medications that work for motion sickness and typical forms of dizziness, such as meclizine or scopolamine, are not effective in either treatment or prevention of MdDS.
- There is evidence that benzodiazepines or SSNI/SSRIs may have beneficial effects in the treatment of MdDS symptoms.
- Many patients have reported a benefit from exercise.
NOTE: In efforts to find relief of MdDS symptoms, alternative medications including herbal supplements have been tried by many. Little is known regarding the side-effects or toxicity of these compounds when either taken alone or in combination. However, the interactions of some of these compounds with prescribed drugs are well-recognized and caution is encouraged. Always consult your doctor before beginning any treatment.
- There is no known clinical study regarding the prevention of MdDS. Medication such as benzodiazepines might be tried prior to a motion experience if the disorder is related to inappropriate vestibular adaptation. For persons with a history of MdDS, it is suggested that they avoid further exposure to oscillating motion experiences, as many patients have reported recurrences.
- Our support group members suggest reducing stress and being well rested prior to travel. EarPlanes® or FlyFit® earplugs are used by some members when flying. Refer to the Coping Tips section for more tips on travel.