Mal de debarquement

Objectives To better define mal de debarquement ("sickness of disembarkment") syndrome, to understand the etiology or mechanism of this disorder, and to seek better prevention and treatment options for this disorder. Design Patient survey of clinical features. Setting Participants were recruited via advertisement in the newsletter of the Vestibular Disorders Association, Portland, Ore. Patients Twenty-seven individuals with mal de debarquement syndrome were identified. To be included in the study, patients must have experienced at least 1 month of rocking or swaying following a cruise or airplane trip of at least 4 hours in duration. Intervention A questionnaire was administered. Main Outcome Measure Clinical features of mal de debarquement syndrome. Results Nearly all respondents were middle-aged women (26 of 27; mean age, 49.3 years). The duration of symptoms ranged from 6 months to 10 years (mean, 3.5 years; SD, 2.5 years). The symptoms were constant in 23 (85%) patients. Neither meclizine hydrochloride nor transdermal scopolamine was helpful. Benzodiazepines were of the most benefit. Balance rehabilitation physical therapy was undertaken by 15 patients, who on average reported a small benefit. Conclusions More than double the number of previously reported cases of mal de debarquement syndrome were identified by this study. The syndrome usually occurs in middle-aged women following an ocean cruise. Symptoms are often refractory to vestibular suppressants as well as physical therapy.