Mal de Debarquement Syndrome: Treatment in an Audiology Balance Center

Being a native Michigander, I grew up being surrounded by water. Fishing is one of my hobbies and, accordingly, I would find any excuse I could to get on the water. After a long day of fishing on a choppy lake, upon landing the boat, I would occasionally notice a strange feeling of the ground moving like I was still in the boat on the water.

Although this feeling only lasted a few moments, it was somewhat disconcerting. For some, however, the symptoms of rocking or swaying persist for much longer and can cause significant distress. The term for this phenomenon is Mal de Debarquement Syndrome (MdDS).

MdDS symptoms are often described as an oscillatory sensation (e.g., rocking) that is present most time following exposure to passive motion (e.g., cruise ship or airplane). Symptoms of MdDS are reduced or eliminated when the individual reengages being moved passively (e.g., driving in a car). A diagnosis of MdDS can be considered when patients experience the events above and have had symptoms for more than 48 hours.[1]

MdDS is characterized as a functional disorder. There is a growing recognition in the medical community that there are illnesses that may be caused by abnormal functioning of physiological systems, yet the cellular and structure are intact.[2] Another example of a functional disorder is persistent postural perceptual dizziness (PPPD).

In the past two decades, there have been significant strides in rehabilitation and treatment for patients with MdDS. One treatment protocol that has emerged and shown efficacy is the use of full-field optokinetic stimulation coupled with head movement.[3] This is a technique where individuals are subjected to a full-field optokinetic stimulus while simultaneously rolling the head.

In this month's issue of the Journal of the American Academy of Audiology, my Michigan neighbors in Grand Rapids present a fascinating case that provides a clear description of MdDS and their approach to treatment for a patient who presented to them with significant symptoms. Those of us who evaluate and treat dizzy patients will inevitably encounter patients with symptoms of MdDS and this case study by Dr. Mike Hojnacki and his team provides a good example of the methods and approach to help alleviate these patients' symptoms.

Publication History

Article published online:
20 May 2024

• References

• 1 Cha YH, Baloh RW, Cho C. et al. Mal de Débarquement Syndrome Diagnostic Criteria: Consensus Document of the Classification Committee of the Bárány Society. J Vestib Res 2020; 30 (05) 285-293
• 2 Graham MK, Staab JP, Lohse CM, McCaslin DL. A Comparison of Dizziness Handicap Inventory Scores by Categories of Vestibular Diagnoses. Otol Neurotol 2021; 42 (01) 129-136
• 3 Dai M, Cohen B, Cho C, Shin S, Yakushin SB. Treatment of the Mal de Debarquement Syndrome: A 1-Year Follow-up. Front Neurol 2017; 8: 175