Monday, April 1, 2024

An uncommon cause of headache and dizziness after cruise travel: case report of Mal De Debarquement syndrome

dizziness after cruise

Whether it’s the constant motion of the ship or the conflicting signals received by our sensory systems, these factors can disrupt our balance and increase feelings of dizziness. If you’re still experiencing motion sickness symptoms after your cruise, the Cleveland Clinic recommends seeing a healthcare provider. They can help determine if you’re experiencing mal de debarquement syndrome, a rare condition that causes a feeling of motion sickness even after you’re no longer in motion. Obtaining a diagnosis has proven challenging for MdDS patients around the world due to the lack of clear biomarkers (i.e. objective measurable data), and the lack of awareness of the condition 27.

How to Cure Vertigo after a Cruise Ship Vacation

We propose that people develop a predictive model of the boat motion, and use their prediction to select the rule to apply for boat motion (and avoid falling). Then vision, vestibular and somatosensation senses are activated by the bodily rotation with respect to the boat, and an active response is needed to prevent a fall. Thus for surge of the boat, no relative sensory reweighting would be needed, although increased responses to all types of input might be helpful. A similar hypothesis was developed by Cohen et al (2018) -- from the same lab -- see next section.

Our suggestions for physical activity:

In addition to medication and therapy, there are other steps you can take to manage your motion sickness. In some cases, your doctor may refer you to a neurologist, who specializes in disorders of the nervous system. They may also order blood tests or a hearing exam to rule out other possible causes of your symptoms. These bands apply pressure to certain points on your wrist that are believed to help alleviate nausea and vomiting. When you’re feeling nauseous or dizzy, getting some fresh air can help provide relief.

Middle-aged Women

Both my kids have issues with car sickness, my son can get it just from normal riding in a car, my daughter gets it if she does things on her phone/tablet. I've only felt moments of queasiness during one cruise but the seas were particularly rough. Another valuable step to take if you get vertigo after a cruise is to get evaluated by a Vestibular Specialist. One research study found that communication problems between the brain and the inner ear were likely to blame for the MdDS symptoms. For someone who has a feeling of rocking after returning from a boat, plane, or train ride, or a long car trip, the first step is to report your symptoms to your Primary Care physician.

Finally I tried prescription meclizine and then  Bonine, and that worked the best of all. We've been cruising for many years and now I don't really need anything, but I never want to re-live that first journey. The treatments for MdDS are still being developed and refined, but many patients are having successful outcomes at these specialized treatment centers.

As the Barany society "consensus criteria" includes the criterian E. Usually the basics here would include (at least) an audiogram, oVEMP, vHIT, and ideally a rotatory chair (see below). Stoffregen et al (2013) also studied a different group than the usual MdDS sufferers students of average age 20.68 years, oddly enough, without reporting their gender. Like Naichum et al, they defined MdDS to be land sickness, and thus they were studying something other than MdDS, but calling it MdDS. They defined "Low-MD" as symptoms for 30 minutes or less, and "High-MD" as symptoms for 120 minutes or more.

dizziness after cruise

As of 2019, a search of Pubmed for titles including "mal de debarquement" in the title turned up only about 56 papers. Considering that many other obscure conditions have 1000's of papers written about them, this means that MdDS has been generally ignored. We have not found that MdDS patients exhibit abnormally large vestibular gains or abnormally long time constants on rotatory chair tests. They generally test normally on the rotatory chair, unless they are taking benzodiazepines such as clonazepam or diazepam (which decrease VOR gain and increase VOR time constants).

How is mal de débarquement syndrome (MdDS) diagnosed?

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A recent hypothesis was offered that MdDS is related to an imbalance of CGRP. This is a bit hard to follow in as much as CGRP modulates vascular tone. Although there are now new drugs that inhibit CGRP for migraine headache., these monoclonal antibody based drugs do not generally get into the brain. Our observation is that drugs generally dol not help MdDS, and at this writing, we don't think they are worth pursuing. There is some effort to attribute MdDS to a "functional" condition called PPPD (triple-PD). We think that the symptoms of MdDS, vestibular migraine, and PPPD overlap to such an extent that this is not a meaningful exercise.

Vertigo After a Cruise Ship Vacation

It’s the nausea, sweating, and dizziness some people experience when the balance system is stimulated in an unexpected way. There are several over-the-counter medications and natural remedies that can help with motion sickness. Ginger, for example, has been shown to be effective in reducing nausea and vomiting. You can take ginger supplements or bring ginger tea or candies with you on your trip. Other options include acupressure wristbands, which apply pressure to a specific point on your wrist to help alleviate symptoms, and over-the-counter medications like Dramamine.

Your body relies on visual cues, such as a stable horizon, to maintain balance. This conflicting sensory information can lead to a sensation commonly known as seasickness, which includes symptoms like dizziness, nausea, and vomiting. Currently, there is no definitive treatment for persistent MdDS as it is not preceded by an infection or other illness. There is no definitive diagnostic test and this disorder rarely responds to medications. Researchers have tried various approaches to alleviate the symptoms and improve the quality of life for affected individuals.

MdDS is the acronym for Mal de Débarquement Syndrome (Fr.), which translates to sickness upon disembarking (leaving a boat or other vehicle). Ongoing research projects regarding MdDS include several by Dr. Cha, several by Dr. Mucci, some in Belgium (Van Ombergen), and in Ohio (Dr Clark). Medications taken prior and during boat travel might prevent development of MdDS.

If you tried sleeping, home remedies, and physical activity, and nothing seems to work; it may be time to see a doctor, especially if the symptoms have lasted more than two days. In this case, you may be suffering from a severe case of MdDS that requires medical intervention to cure. Some people swear by ginger when it comes to relieving vertigo symptoms. You can also try acupressure wrist bands, which are excellent for relieving sea-sickness and are believed to be equally beneficial for curing post-cruise vertigo. If you’re diagnosed with Mal de Debarquement, your doctor will most likely advise you to see a physical therapist specializing in vestibular rehabilitation. The program involves various exercises aimed at improving balance and reducing dizziness-related symptoms.

It occurs when there is a disconnect between the movement your body feels and what your eyes see. When you’re on a cruise ship, your body is constantly adjusting to the rolling and rocking motions of the vessel. The constant movement can confuse your senses, causing dizziness and related symptoms. When first arriving on a cruise ship, the brain and body must adapt to the pitching and tilting that naturally occurs. Over the course of a few days, the brain adapts to the point where it can proactively anticipate the boat’s motions.

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