Mal de Débarquement Syndrome (MdDS)

What is mal de débarquement syndrome (MdDS)?

Mal de débarquement syndrome (MdDS) — which means, “sickness of disembarkation” — is a rare condition that makes you feel like you’re moving, even when you’re not. “Disembarkation” is a word to describe getting off a boat or aircraft. This can cause a change in your stability or balance.

MdDS commonly occurs after boating or sea travel, though it can happen after air travel, extended land travel and even sleeping on water beds. In some cases, MdDS can occur after non-motion events (like surgery or childbirth), or for no known reason (spontaneous mal de débarquement syndrome).

MdDS is a vestibular disorder, meaning it affects your body’s balance system. Vestibular disorders typically originate in your brain or inner ear. Experts believe that MdDS has to do with your brain’s ability to readapt to your surroundings once unfamiliar movement (like sailing on the water) stops.

How common is MdDS?

Mal de débarquement syndrome (MdDS) is rare. Some studies suggest that approximately 150,000 people in the U.S. States have the condition.

Anyone can get MdDS, though 85% of cases affect people assigned female at birth (AFAB) ages 30 to 60. MdDS is also more common in people who get migraines.

What are the symptoms of mal de débarquement syndrome (MdDS)?

MdDS symptoms typically include:

• Rocking, swaying or bobbing sensations.
• Unsteadiness.
• Balance issues.
• Confusion.
• Anxiety.
• Depression.
• Brain fog.

These symptoms typically worsen when you’re standing still or lying down. Unlike some other vestibular disorders, MdDS doesn’t cause tinnitus (ringing in your ears), vomiting, hearing loss or spinning sensations.

What triggers mal de débarquement syndrome (MdDS)?

The most common cause of mal de débarquement syndrome (MdDS) is sea travel or other water-based activities. For example, people who board a cruise ship usually have to acclimate (adjust) to the new and constant motion of being on water.

Once they “have their sea legs,” they can move about the ship without running into walls. Once back on shore, most people “get their land legs back” within two days. People with MdDS still feel like they’re rocking and swaying, even though they’re no longer on a ship.

Less common MdDS triggers include:

• Flying in a plane.
• Extended land travel (by car or train).
• Riding elevators.
• Walking on docks.
• Sleeping on water beds.
• Using virtual reality goggles.

Spontaneous mal de débarquement syndrome — or non-motion MdDS — triggers could result from stressful life events like:

• Childbirth.
• Surgery.
• Head trauma.

How is mal de débarquement syndrome (MdDS) diagnosed?

If your primary care physician (PCP) thinks you could have MdDS, they can refer you to an otolaryngologist or neurologist for an evaluation. Typically, this happens if you’ve had symptoms for at least one month.

There’s no test that can give you a definitive MdDS diagnosis. Instead, healthcare providers run tests to rule out other similar conditions like vestibular migraines. These tests may include:

• Blood tests.
• Hearing tests.
• Balance tests.
• Imaging tests like CT (computed tomography) scans or MRI (magnetic resonance imaging).

In 2020, an international organization called the Bárány Society published diagnostic criteria for MdDS in the International Classification of Vestibular Disorders (ICVD). This collection of information helps healthcare providers around the world to diagnose MdDS using the same standards and guidelines.

How do you get rid of mal de débarquement syndrome (MdDS)?

There isn’t one surefire way to cure MdDS. Oftentimes, it goes away on its own.

In the meantime, there are ways to ease your symptoms, but treatments work differently for everyone. You may have to try several things before you find something that works for you.

MdDS treatments may include:

• Medication.
• Brain stimulation therapy.
• Treatment exercises (vestibular rehabilitation).

Medication

Contrary to what you might think, motion sickness medications won’t improve MdDS symptoms. But sometimes, medications used to treat anxiety, depression and insomnia may help reduce your discomfort.

If you have MdDS and you also get frequent migraines, your healthcare provider may recommend migraine medications. In some cases, these drugs can help with MdDS symptoms.

Brain stimulation therapy

This newer therapy uses electrical signals to activate or inhibit (suppress) different parts of your brain. During the procedure, a healthcare provider will connect special electrodes to your scalp. Brain stimulation therapy can potentially retrain your brain to overcome MdDS symptoms.

Mal de débarquement treatment exercises

Also known as vestibular rehabilitation therapy, these exercises can help you manage balance issues brought on by MdDS. Specific therapies may include balance retraining and eye movement control.

A healthcare provider can recommend a program tailored to your specific needs. It may take several sessions before you notice results.

How long does it take to recover from MdDS?

The answer to this question is different for everyone. While most people recover in 24 hours, some recover in a week or two. Others may have lingering symptoms for a year or longer.

Can MdDS be prevented?

Other than permanently avoiding the trigger that caused your symptoms, there’s no way to prevent MdDS. If you’re prone to MdDS episodes, talk to your healthcare provider about medications that might help.

How long does MdDS last?

In most cases, MdDS goes away within the first 24 hours. Even without treatment, most people improve within one year. However, in rare instances, people may experience symptoms for months or even years.

Does mal de débarquement go away on its own?

Yes, in most cases, people with MdDS notice improvement within 24 hours.

What’s it like living with mal de débarquement syndrome (MdDS)?

MdDS usually goes away on its own within 24 hours. If it doesn’t, your healthcare provider will probably need to rule out other conditions, like vestibular migraines. This may take some trial and error. Though it may be frustrating, it can take a while to find a solution that works best for you.

When should I see my healthcare provider?

If you have the sensation of moving even when you’re not, you should tell a healthcare provider — especially if your symptoms last longer than 24 hours.

What questions should I ask my doctor?

If you have MdDS, here are some questions you might want to ask your healthcare provider:

• What are my treatment options?
• How long do you think my treatment will take?
• When can I expect to see results?
• What can I do to ease my symptoms in the meantime?

A note from Cleveland Clinic

Mal de débarquement syndrome is rare. Though symptoms usually get better within 24 hours, they can last for months or even years in some cases. It can be difficult to navigate the feelings and emotions you may have, especially with prolonged symptoms. Talking with others who are going through the same thing can be beneficial for your mental and emotional well-being. Ask your healthcare provider for additional resources and whether there are new treatments that could work for you.