Mal de debarquement

Objectives: To better define real 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.