Treatment Options in Mal de Débarquement Syndrome: A Scoping Review

Kinkhabwala, Corin; Yuen, Erick; Brennan, Emily; Cadena, Angel; Rizk, Habib G.

doi:10.1097/mao.0000000000003832

Cited by 5 publications

(6 citation statements)

References 63 publications

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“…This is probably why their symptoms are ongoing. The actual review article (1) has shown a low success rate of vestibular rehabilitation, which agrees with the aforementioned description.…”

supporting

confidence: 86%

“…The valuable review article by Kinkhabwala et al (1) concerning treatment options of mal de débarquement syndrome (MdDS) highlighted the need for collaboration because of the rarity of the disease process. Based on our clinical experience of more than thousand patients suffering from chronic multicanalicular benign paroxysmal positional vertigo (mc-BPPV), we consider mc-BPPV as a major cause of MdDS.…”

mentioning

confidence: 99%

“…Vestibular migraine is considered explained via the vestibulothalomocortical reflex (11,12). Migraine prophylactics seem to have a positive effect on MdMS (1).…”

mentioning

confidence: 99%

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Chronic Multicanalicular BPPV as a Possible Cause of mal de Débarquement Syndrome

Tjell¹,

Iglebekk²

2023

Otol Neurotol

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“…This is probably why their symptoms are ongoing. The actual review article (1) has shown a low success rate of vestibular rehabilitation, which agrees with the aforementioned description.…”

supporting

confidence: 86%

mentioning

confidence: 99%

See 1 more Smart Citation

Chronic Multicanalicular BPPV as a Possible Cause of mal de Débarquement Syndrome

Tjell¹,

Iglebekk²

2023

Otol Neurotol

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“…Another drawback of these types of medications is their potential for addiction [ 8 ] and the development of tolerance [ 17 ], limiting prolonged usage. Other non-specific treatments, such as standard vestibular rehabilitation, chiropractic treatments, vestibular suppressants, and counselling, have been trialed with no substantial benefits [ 12 , 16 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing the synergistic effectiveness of intermittent theta burst stimulation and the vestibular ocular reflex rehabilitation protocol in the treatment of Mal de Debarquement Syndrome: a randomised controlled trial

Browne,

Sheeba,

Astill

et al. 2024

J Neurol

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Introduction Mal de Debarquement Syndrome (MdDS) is a rare central vestibular disorder characterised by a constant sensation of motion (rocking, swaying, bobbing), which typically arises after motion experiences (e.g. sea, air, and road travel), though can be triggered by non-motion events. The current standard of care is non-specific medications and interventions that only result in mild-to-moderate improvements. The vestibular ocular reflex (VOR) rehabilitation protocol, a specialised form of rehabilitation, has shown promising results in reducing symptoms amongst people with MdDS. Accumulating evidence suggests that it may be possible to augment the effects of VOR rehabilitation via non-invasive brain stimulation protocols, such as theta burst stimulation (TBS). Methods The aim of this randomised controlled trial was to evaluate the effectiveness of intermittent TBS (iTBS) over the dorsolateral prefrontal cortex in enhancing the effectiveness of a subsequently delivered VOR rehabilitation protocol in people with MdDS. Participants were allocated randomly to receive either Sham (n = 10) or Active (n = 10) iTBS, followed by the VOR rehabilitation protocol. Subjective outcome measures (symptom ratings and mental health scores) were collected 1 week pre-treatment and for 16 weeks post-treatment. Posturography (objective outcome) was recorded each day of the treatment week. Results Significant improvements in subjective and objective outcomes were reported across both treatment groups over time, but no between-group differences were observed. Discussion These findings support the effectiveness of the VOR rehabilitation protocol in reducing MdDS symptoms. Further research into iTBS is required to elucidate whether the treatment has a role in the management of MdDS. TRN: ACTRN12619001519145 (Date registered: 04 November 2019).

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“…It affects their employability, social life, and will to live ( 2 , 4 ). While there exists a range of treatment options, including pharmacological interventions, neuromodulation, and vestibulo-ocular reflex (VOR) rehabilitation, their accessibility is limited, or they primarily address secondary symptoms rather than resolving the underlying issue ( 5 ). Therefore, adequate treatment options capable of diminishing MdDS symptoms are of great importance.…”

Section: Introductionmentioning

confidence: 99%

Guideline for standardized approach in the treatment of the Mal de Debarquement syndrome

Schoenmaekers,

Jillings,

De Laet

et al. 2024

Front. Neurol.

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IntroductionMal de Debarquement Syndrome (MdDS) is a debilitating neuro-otological disorder. Patients experience almost continuously a perception of self-motion. This syndrome can be motion-triggered (MT-MdDS), such as on a boat, or occur spontaneously or have other triggers (SO-MdDS) in the absence of such motion. Because the pathophysiological mechanism is unknown, treatment options and symptom management strategies are limited. One available treatment protocol involves a readaptation of the vestibular ocular reflex (VOR). This study assesses the effectiveness of vestibulo-ocular reflex (VOR) readaptation in 131 consecutive patients with a fixed protocol.MethodsWe administered 131 treatments involving optokinetic stimulation (OKS) paired with a fixed head roll at 0.167 Hz over two to five consecutive days. Each day, four-minute treatment blocks were scheduled twice in the morning and afternoon. Treatment effectiveness was evaluated through questionnaires and posturography.ResultsWe observed significant improvements in the visual analog scale (VAS), MdDS symptom questionnaire, and posturography measures from pre- to post-treatment. No significant differences were found in outcome variables between MT- and SO-MdDS onsets.ConclusionSymptoms improved subjectively and objectively in patients’ post-treatment. The overall success rate was 64.1%, with no significant difference between MT (64.2%) and SO (63.3%). This study supports the conclusion that VOR readaptation treatment provides relief for two-thirds of MdDS patients, irrespective of the onset type. Based on consistency in the findings, we propose a standardized method for treatment of MdDS based on the OKS with head roll paradigm.

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Treatment Options in Mal de Débarquement Syndrome: A Scoping Review

Cited by 5 publications

References 63 publications

Chronic Multicanalicular BPPV as a Possible Cause of mal de Débarquement Syndrome

Chronic Multicanalicular BPPV as a Possible Cause of mal de Débarquement Syndrome

Assessing the synergistic effectiveness of intermittent theta burst stimulation and the vestibular ocular reflex rehabilitation protocol in the treatment of Mal de Debarquement Syndrome: a randomised controlled trial

Guideline for standardized approach in the treatment of the Mal de Debarquement syndrome

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