Mal de debarquement syndrome: A forgotten entity?

Abstract

Mal de debarquement syndrome is defined by a persistent sensation of rocking and swaying commonly felt with sea travel that is first noted on return to land. Mal de debarquement syndrome is not to be confused with seasickness, which causes nausea, vomiting, diaphoresis, and headache. Four female patients with mal de debarquement syndrome are reviewed. Mal de debarquement is normally a short-lived phenomenon. The need for extensive evaluations may be avoided by an awareness of this entity.

Mal de Debarquement presenting in the Emergency Department

“…Mal de debarquement (MDD) is a common, transient sensation of disequilibrium that is most frequently triggered after disembarking from an oceangoing vessel (1)(2)(3). Literally "the sickness of disembarking," it is a distinct entity from seasickness or other forms of motion sickness in that associated symptoms, such as headache, nausea, and vomiting, are absent (1,2).…”

“…Literally "the sickness of disembarking," it is a distinct entity from seasickness or other forms of motion sickness in that associated symptoms, such as headache, nausea, and vomiting, are absent (1,2). The offending sensation-one of still being aboard ship-is only triggered after a return to solid ground, and may actually be relieved by re-boarding the vessel.…”

“…Whereas the literature concerning MDD offers varying definitions, most authors describe the disorder as short-lived and with spontaneous resolution (2,(5)(6)(7). Although the symptoms of MDD can be quite distressing, they classically result in no long-term morbidity.…”

Phobic postural vertigo

“…Three other conditions resemble PPV: space phobia [18], "Mal de débarquement syndrome" [7,19], and "visual vertigo" [5]. Space phobia, a pseudo-agoraphobic syndrome, describes a fear of absent visuospatial support for balance (open spaces) and of falling.…”

Mal de debarquement: Pseudo-hallucinations from vestibular memory?

“…Some authors have suggested dysfunction of the vestibular system by overstimulation [8]. This mechanism, however, seems unlikely for two reasons: Firstly, vestibular function tests are consistently normal in patients with MdD and, secondly, the vestibular system itself cannot prolong vestibular information beyond 2 or 3 minutes, as accomplished by the socalled velocity storage mechanism (which is the one that makes us feel spinning for a while after leaving a carousel).…”