Have you ever stepped off the ship after a relaxing cruise, only to find that the dizzying sensation of being on a rocking ship persists, even on solid ground?
Cruise-induced dizziness, also known as mal de débarquement syndrome (MdDS), is a vestibular disorder characterised by a persistent sensation of swaying or rocking, often triggered by an extended period at sea. Unlike vertigo, there is no spinning sensation.
Although the exact mechanisms triggering this response remain a subject of ongoing research, several factors contribute to the development of this unsettling sensation.
While mal de débarquement syndrome has only recently been recognised as a distinct neurological disorder, mentions of the condition can be found in historical literature and texts.
One of the earliest mentions of the disorder dates back to the 18th century, when Dr Prosper Ménière, a French physician, noted that people who disembarked ships after travelling for a long time would experience a persistent rocking sensation, naming it ‘mal de débarquement’, meaning ‘sickness of disembarkation’ in French. However, the term mal de débarquement syndrome was only coined in the late 20th century by Dr A. M. Hain to describe the prolonged form of this disorder.
While the exact causes are not known the most prevailing theory suggests that MdDS may arise from an imbalance in the brain’s vestibular system, responsible for maintaining balance and spatial orientation. The prolonged exposure to motion disrupts the brain’s ability to readjust to stable conditions, leading to the persistent rocking sensation. Other factors, such as hormonal changes, stress, and individual susceptibility, may also contribute to the development of MdDS.
Common symptoms include pain in the ear, neck and back, accompanied by chronic fatigue. Extreme sensitivity to light and smell can also be present with persistent MdDS. In rare cases, there are reports of cognitive impairments, such as difficulty with memory and concentration. Symptoms can worsen due to lack of sleep, lifestyle changes and stress.
While many uncertainties remain, existing research consistently highlights a significant prevalence of MdDS in perimenopausal women, usually in their 40s, with a ratio of 9:1 compared to males. One clinical assessment carried out by Dr Hain, found that 80 per cent of the affected participants in the study were female, with a majority of them being post-menopausal.
MdDS is not directly related to migraines, although there may be some correlation or a previous illness that triggered it. Motion, such as driving a car, can temporarily alleviate the symptoms, but they immediately return afterwards. The condition can be debilitating, affecting daily life, work and social activities, resulting in a reduced quality of life and potential anxiety or depression.
Currently, there is no definitive treatment for persistent MdDS as it is not preceded by an infection or other illness. There is no definitive diagnostic test and this disorder rarely responds to medications. Researchers have tried various approaches to alleviate the symptoms and improve the quality of life for affected individuals. One common treatment option is vestibular rehabilitation therapy, which involves exercises and manoeuvres to retrain the brain’s balance mechanisms.
Medications such as benzodiazepines and selective serotonin reuptake inhibitors may help manage symptoms such as anxiety and dizziness.
In certain instances, this disorder can resolve spontaneously. However, in the majority of documented cases, the sensation persists for days or even months following the triggering event. Research indicates that the longer the symptoms persist, the lower the chances of the individual ever recovering.
Some patients have also reported feeling relief through non-invasive brain stimulation techniques such as transcranial magnetic stimulation. However, the effectiveness of these approaches varies among affected individuals, highlighting the need for further research.
Preventing MdDS entirely is challenging, as the triggers are unpredictable and unavoidable in certain situations. However, there are some measures such as gradual exposure to motion, maintaining a healthy lifestyle and managing stress that can be undertaken by individuals to minimise the risk of developing MdDS or to alleviate symptoms if they occur.
Have you ever experienced mal de débarquement syndrome? Have you ever felt dizzy after a cruise? Let us know in the comments section below.
Also read: Six items not to pack for a cruise
Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.