Last year, a young woman from Idaho experienced dizziness and decreased balance after watching fireworks from a boat on the Fourth of July. While she suspected the loud fireworks as the cause, it is more likely that her symptoms were related to a lesser-known phenomenon called Mal de Debarquement (MDD).
In this article, we will delve into the intriguing world of Mal de Debarquement, its causes, symptoms, and potential treatments.
Understanding Mal de Debarquement
Mal de Debarquement, a French term meaning “sickness of disembarkment,” refers to a persistent rocking sensation that occurs after exposure to passive motion. It is commonly reported following boat trips but can also occur after flights, long car rides, and even sleeping on a waterbed.
This condition is believed to stem from difficulties in readapting to stable ground after prolonged exposure to motion.
Disorder of Neuroplasticity
Contrary to peripheral vestibular disorders, Mal de Debarquement is thought to be a disorder of neuroplasticity. Patients who experience this condition undergo some form of adaptation to prolonged passive motion, such as the swaying of a ship, and struggle to readapt to a stable environment. Females are overwhelmingly more affected by Mal de Debarquement syndrome.
Common Complaints and Symptoms
Individuals with Mal de Debarquement often describe feeling as if they are still on a moving boat, experiencing a persistent rocking or swaying sensation. They may have difficulty tolerating environments where objects or people are in motion but find temporary relief when in a moving vehicle or back on a boat.
Symptoms commonly experienced in MDD:
- Persistent sensation of rocking, swaying, or movement
- Feeling as if still on a boat or experiencing motion even after disembarking
- Difficulty tolerating environments with moving objects or people
- Relief or improvement of symptoms when in a moving vehicle or back on a boat
- Worsening of symptoms upon returning to stable ground after exposure to motion
- Sensation of imbalance or decreased balance
- Discomfort or uneasiness in situations with visual motion stimuli
- Increased sensitivity to motion triggers
Please note that symptoms may vary from person to person, and not all individuals with MDD will experience the same set of symptoms.
Clinicians may hear patients say things like:
“I feel like I am still on the boat”
“I feel like I am rocking, swaying ever since I got off the boat.”
“ I can’t stand being where things are moving around me”
“I feel better when I am moving in the car/back on the boat.”
Symptoms associated with MDD typically last for a brief duration, with complete resolution within a few days being the norm for the majority of affected individuals. However, a small percentage of patients may experience persistent symptoms for months or even years. Interestingly, some individuals temporarily find relief when re-exposed to passive motion but may experience a worsening of symptoms upon returning to stable ground.
Treatment Approaches
Mal de Debarquement remains a poorly understood phenomenon that can significantly impact an individual’s daily life and well-being.
Managing Mal de Debarquement can be challenging due to its unclear etiology and varying responses to different treatments. Some strategies that have shown promise in alleviating symptoms include vestibular rehabilitation therapy, medication trials, and cognitive behavioral therapy.
References:
- Cha, Y. (2009). Mal de debarquement. Semin Neurol, 29(5), 520-527
- Gordon, C., Spitzer, O., Shupak, A., & Doweck, I. (1992). Survey of Mal de Debarquement. BMJ, 304(6826)
