The symptoms of MdDS include a persistent sensation of movement, such as rocking, moving up and down or swaying. This sensation is often relieved when in passive motion, such as when sitting in a moving vehicle. MdDS is usually triggered by movement, but it can also occur spontaneously. Many people experience the onset of symptoms after getting off a moving vehicle, such as a cruise ship, boat, airplane or car. However, a specific trigger is not required to be diagnosed with MdDS. Other common symptoms include nausea, vomiting, headaches, balance problems, difficulty concentrating and mood swings such as anxiety and depression.

MdDS is a complex disorder that has a major impact on the quality of life of those who have it. The duration of symptoms can range from a few days to several years, and in some cases the condition can last a lifetime. Unfortunately, MdDS is often misdiagnosed and common treatment methods have limited effect.

The exact cause of MdDS is not well understood. Several theories have been proposed, including the possibility that it is a disorder related to the brain’s ability to adapt to changes in balance. MdDS usually occurs after spending time on a boat, and symptoms occur upon returning to solid ground, causing a sensation known as “sea legs.” When on a boat, the brain is constantly affected by the motion of the waves in various directions, such as rolling, rocking, bobbing, pitching, and swaying. The brain adapts to this motion through a reflex called the vestibulo-ocular reflex (VOR) to maintain stable vision when the head is moving. In people with MdDS, there may be an inability to restore normal balance after being exposed to motion, resulting in the persistent sensation of motion.

MdDS occurs when the balance of the body is disturbed due to problems with the two types of vestibular receptors, the otoliths and the semicircular canals. These receptors send information to the brain about the position of the head in relation to space and gravity.

In the case of MdDS, there is an inability to properly integrate these receptors into the balance system, along with problems in the cerebellum (cerebellum) that normally helps to adapt the reflexes. In order for our eyes to focus on our surroundings when we move our heads, cooperation between the balance and visual systems is essential. When the alignment of the vestibulo-ocular reflex is not working properly in MdDS, the sensation of movement occurs. Restoring proper alignment of this reflex is key to resolving the condition.

Research shows that it is possible to retrain the body to adapt, which can alleviate the symptoms of MdDS. A 2014 study titled “Readaptation of the vestibulo-ocular reflex relieves the Mal de Débarquement syndrome” proposed a treatment approach that focused on correcting the maladaptation of the vestibulo-ocular reflex in MdDS. The treatment involved using a special visual stimulus called optokinetic stimuli (OKN) along with head movements in the direction the patient experienced them moving. The goal was to help the body re-adapt the reflex and reduce the perception of their own movement. Of the 24 participants in the study, 17 (70%) became symptom-free after the treatment and remained so for up to four months afterward. This is the treatment we use in our clinic, along with other therapies.