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What is Mal De Debarquement Syndrome (MdDS)?

Under: Migraine

Imagine stepping off a cruise ship or a long flight. Only this time, you feel like you’re still moving long after your feet hit the ground. This is the reality for people who suffer from mal de débarquement syndrome, or MdDS.

Mal de débarquement syndrome is French for “sickness of disembarkment.” Disembarkment meaning returning to land from a ship or a plane.

When you take a cruise or flight, your body has to adjust to the constant movement. This is often referred to as “getting your sea legs.” But for people with MdDS, their sea legs persist after they arrive onshore.

In this article, we’ll cover what MdDS is, common triggers, and treatment options. We’ll also explore the mysterious link between MdDS and migraine.

What Is MdDS?

Mal de débarquement syndrome is a vestibular disorder. Meaning, it affects your balance and sense of orientation.

When your body has a change in movement – whether from a roller coaster, boat, or airplane – your vestibular system needs time to adjust. You may feel like the ground is still moving for a few minutes, even though you’re standing still.

But with MdDS, that feeling persists for days or weeks. And for some people, MdDS symptoms can last for months or even years.

MdDS Symptoms

The main symptom of MdDS is feeling like you’re rocking, bobbing, or swaying even when you’re not moving and on solid ground.

Other MdDS symptoms may include:

  • Balance problems
  • Feeling unsteady
  • Confusion
  • Brain fog
  • Anxiety
  • Depression

Woman experiences brain fog

Unlike motion sickness, people with MdDS generally don’t have nausea or vomiting.

Often MdDS symptoms improve when moving and worsen when staying still.1 For this reason, many people with MdDS notice their symptoms ease when driving.

Some people also find their symptoms improve if they return to the motion that triggered them. For example, say someone had MdDS symptoms when they left a cruise ship for a day trip. They may notice their symptoms fade when they return to the ship.

How Common Is It?

Not at all. It’s estimated that MdDS affects roughly 1 in every 150,000 people.2 Middle-aged women are most at risk, making up to 85% of MdDS cases.2 In general, women in their 40’s are most affected. People with migraine also face a higher risk. More on this later…

What Triggers MdDS?

Sea travel is the most common trigger for mal de débarquement syndrome. Research suggests that for about 61% of people, MdDS symptoms pop up after taking a cruise.3

However, cruise ships aren’t the only culprit. MdDS can be triggered by other types of passive motion, including:

  • Riding elevators
  • Flying in a plane
  • Long car rides
  • Train travel
  • Sleeping on water beds
  • Wearing virtual reality goggles
  • Walking on docks

In some cases, MdDS may be triggered not by passive motion, but by stressful events such as childbirth, surgery, or head trauma.3 And in some cases, MdDS occurs for no apparent reason at all. This is known as spontaneous mal de débarquement syndrome.

MdDS and Migraine Connection

Research suggests there’s a strong link between MdDS and migraine. One study took a close look at 80 MdDS patients. It examined their MdDS triggers, as well as any comorbid disorders.

It found that 23% of people with motion-triggered MdDS had migraine. Plus, 38% of people with spontaneous MdDS had migraine.5

Only about 10% of the general population experience migraine.6 So clearly, there’s a connection between migraine and MdDS. Yet the reason for this connection isn’t fully understood.

The study also found that in motion-triggered MdDS, migraine symptoms tended to start in tandem with the onset of MdDS.5 However, the non-motion group usually experienced migraine before the onset of MdDS.5

How Long Does Mal de Débarquement Syndrome Last?

It’s different for everyone. For most people, MdDS symptoms pass within 24 hours. Yet for others, it may take weeks or even months to recover.

When MdDS symptoms persist for more than a month, it’s known as persistent MdDS.4 Unsurprisingly, patients with persistent MdDS are typically the ones who seek treatment.

How is MdDS Diagnosed?

Because MdDS is rare, you’re unlikely to be diagnosed by a primary care physician. Often, MdDS diagnosis is done by a neurologist or otolaryngologist (ENT).

Even then, diagnosing MdDS can be tricky. That’s because no test can deliver a surefire MdDS diagnosis.

Instead, doctors typically run a series of tests to rule out related disorders, like vestibular migraine.

Testing may include:1

  • Blood tests
  • Cardiac evaluation
  • Brain scans like a CT scan or MRI
  • Vestibular tests like VNG
  • Hearing tests

MdDS Treatment

MdDS symptoms usually resolve on their own. However, if your symptoms persist, there are a few treatments that may offer relief.

Keep in mind that not all treatments work for everyone. You may have to try a few before you find the right fit.

Here are a few MdDS options your doctor may recommend:

Medications: Anti-anxiety medications and antidepressants help for some people with MdDS.1 Some studies suggest migraine prophylaxis drugs like topiramate may also help.7 Motion sickness meds on the other hand typically don’t work with MdDS.1

Brain stimulation: In this form of therapy, electrodes are placed at specific points on your scalp. Electric signals are then sent to stimulate or suppress different areas of your brain. The goal is to retrain your brain to ease MdDS symptoms.8

Vestibular rehabilitation: This type of physical therapy focuses on improving balance. Vestibular rehabilitation for MdDS may include eye movement exercises and balance retraining.

Manage stress: Research shows stress can intensify MdDS symptoms.3 So keeping a healthy lifestyle is important. Regular exercise, getting plenty of rest, and setting aside time for relaxation may offer relief.

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Living with Mal de Débarquement Syndrome

Like migraine, mal de débarquement syndrome is a condition that can make life challenging. Most cases of MdDS resolve on their own within a day. But if you’re one of the unfortunate few whose MdDS symptoms persist, it can be overwhelming.

Be sure to get support from loved ones and talk with your healthcare provider. Living with MdDS is difficult. So do what you can to make your physical and mental well-being your top priority.