J Neurol. 2008 Jul; 255(7): 1038. Published online 2008 May 30


OBJECTIVE: To investigate the clinical features and natural history of mal de debarquement (MdD).

DESIGN: Retrospective case review with follow-up questionnaire and telephone interviews.

SETTING: University Neurotology Clinic.

PATIENTS: Patients seen between 1980 and 2006 who developed a persistent sensation of rocking or swaying for at least 3 days after exposure to passive motion.

MAIN OUTCOME MEASURE: Clinical features, diagnostic testing, and questionnaire responses.

RESULTS: Of 64 patients (75% women) identified with MdD, 34 completed follow-up questionnaires and interviews in 2006. Most patients had normal neurological exams, ENGs and brain MRIs. The average age of the first MdD episode was 39+/-13 years. A total of 206 episodes were experienced by 64 patients. Of these, 104 episodes (51%) lasted>1 month; 18%, >1 year; 15%, >2 years; 12%, >4 years, and 11%, >5 years. Eighteen patients (28%) subsequently developed spontaneous episodes of MdD-like symptoms after the initial MdD episode. There was a much higher rate of migraine in patients who went onto develop spontaneous episodes (73%) than in those who did not (22%). Subsequent episodes were longer than earlier ones in most patients who had multiple episodes.Re-exposure to passive motion temporarily decreased symptoms in most patients (66%). Subjective intolerance to visual motion increased (10% to 66%) but self-motion sensitivity did not (37% to 50%) with onset of MdD.

CONCLUSION: The majority of MdD episodes lasting longer than 3 days resolve in less than one year but the probability of resolution declines each year. Many patients experience multiple MdD episodes. Some patients develop spontaneous episodes after the initial motion-triggered episode with migraine being a risk factor.

Keywords: mal de debarquement, vestibular adaptation, motion sensitivity, visual motion, migraine

Read the full article at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2820362/