The grandfather of Charles Darwin first described this condition in the late 18th century and for many who have spent days on a cruise ship the sensation of the ground moving under their feet once they return to land is a familiar one. Most people will however find this sensation resolving spontaneously within hours. For others it might last days. A very unlucky few however have no relief and describe the same sensation months or years after the initial event.
Unlike most balance disorders, sufferers of Mal de Debarquement Syndrome describe symptoms being worse when they are still, rather than in motion.
Although the history of this condition is typical, it is still necessary to exclude other similar balance disorders. For this reason patients undergo a full neuro-otological examination, audiology, and balance lab testing. Invariably these tests show normal responses. MRI scanning is also normal.
Treatment is based upon the following principles:
- An accurate diagnosis has been made based upon symptoms of a rocking sensation when still, continuing for at least a month after the initial insult (cruise or flight).
- Activities which produce repetitive non realistic balance input to the brain are discouraged. Examples include running on a treadmill, driving long distances without regular breaks etc.
- Medications may be helpful but it is unclear whether they simply relieve associated anxiety or truly hasten a resolution of symptoms.
- Activity is encouraged. Exercise including formalized positional disciplines such as Tai Chi are often helpful.
- Further cruises or flights are discouraged.
- Any associated problems such as migraine etc. should be addressed.
There are several theories as to the cause of this condition but no one truly knows its aetiology.
For a very small number of patients the symptoms can occur without them ever being on a boat, plane or train. These patients are said to have Idiopathic Mal de Debarquement Syndrome and the same treatment principles apply.