Mal de pelea

Mal de debarquement

Mal de debarquement syndrome (MdDS, or disembarkment syndrome) is a rare condition usually occurring after a cruise, aircraft flight, or other sustained motion event. It has only recently received attention and very little real scientific research has been conducted. The phrase "mal de debarquement" is French for "sickness of disembarkation".

Symptoms

Symptoms most frequently reported include a persistent sensation of motion usually described as rocking, swaying, or bobbing; difficulty maintaining balance; extreme fatigue; and difficulty concentrating ("brain fog"). Other common symptoms include dizziness, headaches and/or migraine headaches, confusion, and anxiety. Many patients also describe ear symptoms such as hyperacusis, tinnitus, "fullness", pain, or even decreased hearing. Cognitive impairment ("brain fog") includes an inability to recall words, short term memory loss, and an inability to multi-task.

Interestingly, the condition often abates when the patient is in motion such as in a car, train, plane, or boat. And, symptoms are increased by stress, crowds, flickering lights, loud sounds, fast or sudden movements, enclosed areas or busy patterns.

In MdDS, the symptoms persist for more than 1 month, and possibly many years. This differs from the very common condition of "land sickness" that most people feel for a short time after a motion event such as a boat cruise, airplane ride, or even a treadmill routine.

Epidemiology

The condition is felt to be underreported in the medical literature, where fewer than 100 cases have been studied. A series of 27 cases reported in 1999 (Hain et al. 1999) noted all but one patient to be female. The average age in this series was 49 years.

These trends have recently been confirmed by the MdDS Balance Disorder Foundation (http://www.mddsfoundation.org) in a study of over 100 individuals diagnosed with MdDS. The female:male ratio was approximately 9:1; the average age of onset was 43-45 years.

The most commonly reported inciting event was a prolonged ocean cruise (~45%), however shorter boating excursions (~22%), airplane travel (~15%), and automobile travel (~8%) have all been described.

Diagnosis

MdDS is a diagnosis of exclusion. There are no definitive tests the confirm MdDS, only tests that rule out other conditions.

Treatment

There is no known cure for the condition. In the series cited above, more than 50% of patients had resolution of symptoms within 3 years of onset. For most balance and gait disorders, some form of displacement exercise is thought helpful (for example walking, jogging, or bicycling but not on a treadmill or stationary bicycle). This has not been well-studied in MdDS however. Medications that suppress the nerves and brain circuits involved in balance have been noted to help, but don't seem to offer a permanent cure.

The worst thing a person can do is let a balance disorder limit his or her physical activity, as this will then cause a superimposed "disuse imbalance" or contribute to weight gain and depression. A vicious cycle may ensue.