COMMON VESTIBULAR ISSUES
Mal de Débarquement Treatment Melbourne
The Vertigo Co offer tailored treatment options to help manage the symptoms of Mal de Débarquement syndrome (MdDs).
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What is Mal de Débarquement?
If you’ve travelled for a period of time aboard a boat, ship or plane, you may have experienced an uneasy sense of imbalance or unsteadiness on returning to land. While for most people, this sensation is temporary and subsides after a short period, some individuals will experience persistent and ongoing symptoms long after their travels are over. When this condition becomes chronic (lasting for weeks, months or years) it is referred to as Mal de Débarquement syndrome (from the French “sickness of disembarkment”) or MdDS .
Unlike other common vestibular disorders such as Benign Paroxysmal Positional Vertigo (BPPV) or Vestibular Migraine which are characterised by short episodes of dizziness and balance problems, MdDS symptoms occur consistently and can have a significant impact on quality of life.
Mal de Débarquement Symptoms
Symptoms of Mal de Débarquement syndrome (MdDS) often present as a similar sensation to those experienced while travelling on board a boat or ship. These include feelings of motion such as rocking or swaying, as well as a sense of unsteadiness or dizziness.
In addition to these, MdDs sufferers may also experience:
Extreme tiredness or fatigue that interferes with daily activity
Difficulty concentrating or staying focused or issue with short term memory, often referred to as "brain fog"
Headaches or migraines
Anxiety or depression (often related to emotional distress from the ongoing symptoms and impact on quality of life)
Symptoms can sometimes more pronounced when standing or lying still but may reduce with movement such as travelling in a car. They may also be triggered or worsened by stress and tiredness, visual stimuli such as bright lights or moving screens or walking on soft surfaces such as sand or thick carpet. Symptom intensity can vary from person to person.
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What Causes Mal de Débarquement?
The exact cause of Mal de Débarquement Syndrome is not fully understood. Onset of the syndrome is usually triggered by a period of travel that involves some form of motion – most commonly this occurs on a boat or ship but can also be caused by long flights (turbulence may also be a factor) or extended train or car travel, or even sleeping on a waterbed.
We know that during exposure to motion, the brain adapts to the movement to keep us feeling stable and balanced. In the case of MdDS, it is believed that after periods of prolonged movement, the vestibular system (the areas of the inner ear and brain responsible for balance) may be unable to recalibrate properly, causing a person to experience ongoing sensations or rocking or swaying, even once they are back on solid ground. High levels of stress, anxiety or other emotional factors may play a role in the development of MdDS. Basically, one develops their “sea legs” and is then unable to redevelop their “land legs” again.
While exact causes are unknown, there are several treatment options available to help manage and alleviate symptoms.
How is Mal de Débarquement Diagnosed?
There is no specific test for diagnosing Mal de Débarquement Syndrome (MdDS). It is often identified through evaluation of the symptoms and ruling out of any other vestibular disorders such as BPPV, Ménière’s Disease, Vestibular Neuritis/Labyrinthitis or Vestibular Migraine.
Potential criteria for the diagnosis for MdDS include:
- recent travel or exposure to motion
- a primary symptom of rocking or swaying
- symptoms that temporarily improve with passive motion (e.g. travelling in a car) and worsen when stationary
- associated symptoms of fatigue, brain fog or anxiety
- symptoms that have persisted for a significant length of time (weeks or months)
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Mal de Débarquement Treatment Options
While there is not one clear path to resolving Mal de Débarquement, there are several treatment options available that may help to manage the symptoms.
Vestibular Rehabilitation Therapy
Vestibular Rehabilitation Therapy (VRT), also referred to as Vestibular Physiotherapy, aims to help retrain the brain and vestibular system to recognise and process sensory input correctly. Treatment with VRT may involve balance exercises to assist in regaining balance and coordination, and habituation exercises to gradually desensitise the brain to symptom triggering stimuli.
The Dai Protocol
The Dai Protocol was developed by Dr. Shi Dai specifically for the treatment of Mal de Débarquement Syndrome. The protocol utilises techniques including gradual movement exposure, cognitive and visual motion exercises (such as watching stripes scrolling across a screen while performing guided head tilts) as well as lifestyle modifications focusing on diet, sleep and stress management.
Supplements and Medications
Certain supplements, including magnesium glycinate, Vitamin B2, Vitamin D and Omega-3 fatty acids and Curcumin, may be helpful in relieving some of the symptoms of MdDS. Antidepressants (SSRIs or SNRI) medications which have a dual action in treating Migraine such as Venlafaxine may also sometimes be prescribed. As women in the 40-50 year old age group are among those more commonly impacted by MdDs, addressing any underlying hormone imbalances may also be considered as part of a treatment plan.
Frequently Asked Questions
Mal de Débarquement Syndrome is considered to be a rare disorder. The condition primarily affects women, especially those aged 40 to 50, though it can occur at any age and in men as well. People with a history of migraines or vestibular disorders may also be more prone to developing MdDS.
Yes, while most cases are triggered by travel, spontaneous MdDS can occur without a clear motion event. This is rare but has been linked to neurological factors, migraines, and hormonal changes. Spontaneous cases may respond to similar treatments as motion-triggered MdDS.
Unlike motion sickness, which typically improves once movement stops, MdDS symptoms persist long after the initial motion exposure.
The duration of MdDS varies. Some cases resolve within days or weeks, while others can last months or even years. Treatment with therapies like vestibular rehabilitation or the Dai Protocol may help to improve recovery outcomes.
If you don’t have Mal de Débarquement Syndrome (MdDS), your symptoms could be caused by other conditions like Benign Paroxysmal Positional Vertigo (BPPV), Vestibular Migraine, Ménière’s Disease, or Persistent Postural-Perceptual Dizziness (PPPD). If you are experiencing vestibular symptoms of any kind, booking an appointment at a dedicated vestibular clinic can help in determining a diagnosis and developing the right treatment plan.
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Find Support for Mal de Débarquement Syndrome
If you’re experiencing persistent symptoms of rocking, swaying, or imbalance after travel, our experienced vestibular physiotherapists may be able to help.
Contact The Vertigo Co to book an appointment today.