Mal De Debarquement Syndrome: Brain Problem Not Inner Ear Problem

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By: Dr. John Conde DC, DACNB Special to the Boca and Delray newspapers

“Sickness of Disembarkment” is the translation for Mal De Debarquement Syndrome (MDDS), the French coined dizziness-balance disorder. This disorder refers to the sensory experience of movement or swaying that is normally felt briefly after travelling on water by ship or boat.  However, the updated medical definition now includes other forms of travel such as by airplane, car, train or any novel movement experience such as lying on a water bed or walking on the beach. This perception typically subsides within 24 hours and affects even the most experienced sailors.  Persistent MDDS is when this condition does not subside quickly and lasts from weeks to years.

Persistent MDDS is most common in middle aged women. It is described as a swaying, rocking, and or disequilibrium that actually may go away when moving rapidly as when walking fast or driving in a car. Symptoms are made worse when an individual is motionless or in a small space.  Stress and anxiety are also triggers and can be comorbid, occurring simultaneously.  MDDS does negatively affect an individual’s quality of life.

MDDS is thought to be a disorder of brain processing and of lack of re-calibration after adapting to new movement patterns as such when on a boat. In essence, the brain adapts to new movements when on a boat but fails to return to previous functionality when on stable ground.  Studies have demonstrated changes in brain metabolism and functional connections in those with persistent MDDS.  Specifically, regions in the cerebrum that process movement and balance can be found in the parietal insular vestibular cortex (PIVC). There are also areas in what is termed the posterior parietal lobe and cerebellum that contribute to the lack of returning to equilibrium.

At the moment, MDDS does not have any specific identifying lab test or imaging study.  It is diagnosed with an appropriate, detailed case history and a thorough neurological examination with current technology.  This technology must measure parameters such as eye movements, brain processing speeds, balance, strength, and reflexes. Once a diagnosis is made and specific regions of the brain targeted, precise rehabilitation strategies are implemented to increase the perceptual awareness of the body in space thus re-calibrating the brain. The desired outcome of a reduction or elimination of the feeling of sway is possible because of our understanding of neuroplasticity which states that the brain and neurological connections can change according to the stimulation and activity provided.

Dr. John Conde is a Board Certified Chiropractic Neurologist. His office is located at the Atlantic Grove in Delray Beach and can be reached at 561-330-6096, drconde@thecondecenter.com, www.thecondecenter.com