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. 2008 Jul;255(7):1038-44.
doi: 10.1007/s00415-008-0837-3. Epub 2008 May 30.

Clinical features and associated syndromes of mal de debarquement

Yoon-Hee Cha  1 , Jae Brodsky, Gail Ishiyama, Chiara Sabatti, Robert W Baloh
Affiliations

Clinical features and associated syndromes of mal de debarquement

Yoon-Hee Cha et al. J Neurol. 2008 Jul.

Abstract

Objective: To investigate the clinical features and natural history of mal de debarquement (MdD).

Design: Retrospective case review with follow-up questionnaire and telephone interviews.

Setting: University Neurotology Clinic.

Patients: Patients seen between 1980 and 2006 who developed a persistent sensation of rocking or swaying for at least 3 days after exposure to passive motion.

Main outcome measure: Clinical features,diagnostic testing, and questionnaire responses.

Results: Of 64 patients(75% women) identified with MdD, 34 completed follow-up questionnaires and interviews in 2006. Most patients had normal neurological exams, ENGs and brain MRIs. The average age of the first MdD episode was 39+/-13 years. A total of 206 episodes were experienced by 64 patients. Of these, 104 episodes (51%) lasted>1 month; 18%, >1 year; 15%, >2 years; 12%, >4 years, and 11%, >5 years. Eighteen patients (28%) subsequently developed spontaneous episodes of MdD-like symptoms after the initial MdD episode.There was a much higher rate of migraine in patients who went onto develop spontaneous episodes(73%) than in those who did not(22%). Subsequent episodes were longer than earlier ones in most patients who had multiple episodes.Re-exposure to passive motion temporarily decreased symptoms in most patients (66%).Subjective intolerance to visual motion increased (10% to 66%)but self-motion sensitivity did not(37% to 50%) with onset of MdD.

Conclusion: The majority of MdD episodes lasting longer than 3 days resolve in less than one year but the probability of resolution declines each year. Many patients experience multiple MdD episodes. Some patients develop spontaneous episodes after the initial motion-triggered episode with migraine being a risk factor.

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Figures

Fig. 1
Fig. 1
Kaplan Meier Survival Curve for episode duration. The proportion of 206 MdD episodes that continued past each month is shown here. Crosses represent individual episodes that have been followed for the duration indicated and have not yet resolved. Dashed lines = 95 % confidence interval
See this image and copyright information in PMC

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