Mal de debarquement syndrome, also known as MDDS or MdDS, is a type of vertigo that most often occurs only after stepping off a cruise ship. Although rare, this sense of prolonged dizziness or imbalance can be debilitating. A background understanding of this condition can help to hasten diagnosis and potentially prevent it from occurring after a sea voyage is complete.
When suffering from vertigo after a cruise ship vacation, most people describe a feeling equivalent to trying to walk on a mattress or trampoline. Most begin to experience symptoms as soon as they disembark from the ship, Dr. Timothy C. Hain of the Chicago Dizziness and Hearing Clinic writes, and sufferers feel a rocking sensation as if they are still on the boat. Common symptoms include a motion or bobbing sensation that tends to disappear when moving and reappear when staying still. Many experience extreme fatigue, difficulty concentrating, an unsteady gait, ear ringing and nausea. While symptoms can vary from day to day or even throughout the day, symptoms are usually worst at night.
Mal de debarquement syndrome occurs most commonly in women between the ages of 40 and 50, following a seven-night cruise. In fact, the U.S. MDDS Foundation reports that over 90 percent of all Mal de debarquement syndrome patients are women. Symptoms usually last less than a month, although some suffer for much longer.
While the exact cause is unknown, there are many commonly held opinions in the medical community. A commonly supported idea that the inner ear’s inability to adapt to being on solid ground after experiencing motion causes MDDS.
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. The body then adjusts accordingly and avoids falling. Once the cruise is complete, in most cases, the brain resets itself to its “dry land settings” within a few hours or days. MDDS sufferers are unable to reset, and thus only feel “normal” when exposed to periodic motion like a car ride. Because women are most often affected, sex hormones like estrogen or progesterone may play a role.
Since there is no one test to identify Mal de debarquement syndrome, patients must undergo several tests to rule out other conditions. To arrive at an MDDS diagnosis, a thorough medical history, blood tests, neurological exams, hearing exams and balance exams are necessary.
Once Mal de debarquement syndrome has begun, most motion sickness medications do not work. Low doses of certain anxiety medications--such as clonazepam--can help, as can certain types of antidepressants. The MDDS Foundation reports that some patients experience symptom improvement following physical therapy for the ear and daily exercise.
- Rhine Cruise Ship in Emmerich image by Raoulsch from Fotolia.com